Post-consultation acute respiratory tract infection recovery: a latent class-informed analysis of individual patient data.
antibiotics
general practice
latent class analysis
respiratory tract infections
Journal
The British journal of general practice : the journal of the Royal College of General Practitioners
ISSN: 1478-5242
Titre abrégé: Br J Gen Pract
Pays: England
ID NLM: 9005323
Informations de publication
Date de publication:
03 2023
03 2023
Historique:
received:
05
05
2022
accepted:
11
11
2022
entrez:
23
2
2023
pubmed:
24
2
2023
medline:
3
3
2023
Statut:
epublish
Résumé
There is a lack of evidence regarding post-consultation symptom trajectories for patients with respiratory tract infections (RTIs) and whether patient characteristics can be used to predict illness duration. To describe symptom trajectories in patients with RTIs, and assess baseline characteristics and adverse events associated with trajectories. The study included data about 9103 adults and children from 12 primary care studies. A latent class-informed regression analysis of individual patient data from randomised controlled trials and observational cohort studies was undertaken. Post-consultation symptom trajectory (severity and duration), re-consultation with same or worsening illness, and admission to hospital were assessed. In total, 90% of participants recovered from all symptoms by 28 days, regardless of antibiotic prescribing strategy (none, immediate, and delayed antibiotics). For studies of RTI with cough as a dominant symptom ( Older patients presenting with more severe, longer pre-consultation symptoms and chronic lung disease should be advised they are more likely to experience longer post-consultation illness durations, and that recovery rates are similar with and without antibiotics.
Sections du résumé
BACKGROUND
There is a lack of evidence regarding post-consultation symptom trajectories for patients with respiratory tract infections (RTIs) and whether patient characteristics can be used to predict illness duration.
AIM
To describe symptom trajectories in patients with RTIs, and assess baseline characteristics and adverse events associated with trajectories.
DESIGN AND SETTING
The study included data about 9103 adults and children from 12 primary care studies.
METHOD
A latent class-informed regression analysis of individual patient data from randomised controlled trials and observational cohort studies was undertaken. Post-consultation symptom trajectory (severity and duration), re-consultation with same or worsening illness, and admission to hospital were assessed.
RESULTS
In total, 90% of participants recovered from all symptoms by 28 days, regardless of antibiotic prescribing strategy (none, immediate, and delayed antibiotics). For studies of RTI with cough as a dominant symptom (
CONCLUSION
Older patients presenting with more severe, longer pre-consultation symptoms and chronic lung disease should be advised they are more likely to experience longer post-consultation illness durations, and that recovery rates are similar with and without antibiotics.
Identifiants
pubmed: 36823057
pii: BJGP.2022.0229
doi: 10.3399/BJGP.2022.0229
pmc: PMC9975977
doi:
Substances chimiques
Anti-Bacterial Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e196-e203Informations de copyright
© The Authors.
Références
J Fam Pract. 2002 Apr;51(4):324-8
pubmed: 11978254
Ann Fam Med. 2014 Jan-Feb;12(1):29-36
pubmed: 24445101
BMC Anesthesiol. 2016 Oct 21;16(1):102
pubmed: 27769172
Cochrane Database Syst Rev. 2013 Jun 04;(6):CD000247
pubmed: 23733381
Pediatrics. 2005 Jun;115(6):1455-65
pubmed: 15930204
Br J Gen Pract. 2008 Feb;58(547):88-92
pubmed: 18307851
Lancet Infect Dis. 2014 Mar;14(3):213-9
pubmed: 24440616
JAMA. 2005 Jun 22;293(24):3029-35
pubmed: 15972565
BMJ. 2013 Nov 25;347:f6867
pubmed: 24277339
BMJ. 2001 Feb 10;322(7282):336-42
pubmed: 11159657
BMC Fam Pract. 2020 Jun 24;21(1):119
pubmed: 32580696
Fam Pract. 2018 Dec 12;35(6):676-683
pubmed: 29897430
BMJ Open. 2019 Feb 15;9(2):e025396
pubmed: 30772860
BMJ Open. 2017 Nov 26;7(11):e016903
pubmed: 29180593
BMJ Open. 2019 Jan 21;9(1):e026925
pubmed: 30670532
Br J Gen Pract. 2012 Sep;62(602):e639-46
pubmed: 22947585
JAMA Intern Med. 2016 Jan;176(1):21-9
pubmed: 26719947
Ann Intern Med. 2016 Mar 15;164(6):425-34
pubmed: 26785402
BMJ. 2014 Mar 06;348:g1606
pubmed: 24603565
BMJ Open. 2020 Oct 19;10(10):e038851
pubmed: 33077568
Ann Fam Med. 2021 May-Jun;19(3):232-239
pubmed: 34180843
Pediatrics. 2008 May;121(5):e1352-6
pubmed: 18450878
BMJ. 1997 Mar 8;314(7082):722-7
pubmed: 9116551
Cochrane Database Syst Rev. 2013 Nov 05;(11):CD000023
pubmed: 24190439
BMJ. 2013 Dec 11;347:f7027
pubmed: 24335668
Fam Pract. 2001 Oct;18(5):553-4
pubmed: 11604383
Cochrane Database Syst Rev. 2017 Sep 07;9:CD004417
pubmed: 28881007
Pediatrics. 2021 Mar;147(3):
pubmed: 33574163
Lancet Infect Dis. 2019 Jan;19(1):56-66
pubmed: 30409683
Patient Prefer Adherence. 2017 Mar 15;11:561-569
pubmed: 28352162
BMJ Open. 2014 Oct 27;4(10):e006245
pubmed: 25348424
Dev Psychol. 2009 May;45(3):652-76
pubmed: 19413423
J Hosp Infect. 2019 Apr;101(4):426-427
pubmed: 30826342
Br J Gen Pract. 2012 Jun;62(599):e429-37
pubmed: 22687236
Lancet Respir Med. 2016 Nov;4(11):902-910
pubmed: 27594440
BMJ. 2021 Apr 28;373:n808
pubmed: 33910882