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Antibiotic prescribing for discoloured sputum in acute cough/LRTI

Antibiotic prescribing for discoloured sputum in acute cough/LRTI
Antibiotic prescribing for discoloured sputum in acute cough/LRTI
We investigated whether discoloured sputum and feeling unwell is associated with antibiotic prescribing and benefit from antibiotic treatment for acute cough/lower respiratory tract infection in a prospective study of 3402 adults. in 13 countries.

A two-level model investigated the association between producing discoloured sputum or feeling generally unwell and an antibiotic prescription. A three-level model investigated the association between an antibiotic prescription and symptom resolution.

Patients producing discoloured sputum were prescribed antibiotics more frequently than those not producing sputum (OR: 3.2, 95% CI: [2.1, 5.0]), unlike those producing clear/white sputum (OR: 0.95, 95% CI: [0.61,1.48]). Antibiotic prescribing was not associated with greater rate or magnitude of symptoms score resolution (as measured by 13 item scale completed by patients each day) among those who: produced yellow (Coefficient: 0.00, p-value: 0.68) or green sputum (Coefficient: ?0.01, p-value: 0.11); reported any of three categories of feeling unwell; produced discoloured sputum and felt generally unwell (Coefficient: ?0.01, p-value: 0.19).

Adults with acute cough/LRTI presenting in primary care with discoloured sputum were prescribed antibiotics more often compared to those not producing sputum. Sputum colour, alone or together with feeling generally unwell was not associated with recovery or benefit from antibiotic treatment.
acute cough, antibiotic resistance, antibiotic treatment, lower respiratory tract infection, primary care sputum
0903-1936
Butler, C.C.
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Kelly, M.J.
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Hood, K.
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Schaberg, T.
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Melbye, H.
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Serra-Pratf, M.
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Blasi, F.
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Little, P.
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Verheij, T.
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Molstad, S.
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Godycki-Cwirko, M.
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Edwards, P.
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Almirall, J.
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Torres, A.
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Rautakorpi, U-M.
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Nuttall, J.
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Goossens, H.
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Coenen, S.
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Butler, C.C.
736f78ad-3e18-4c63-900f-c2249577b645
Kelly, M.J.
490f28a3-e40d-4005-bf8c-7b41a21bfb60
Hood, K.
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Schaberg, T.
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Melbye, H.
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Serra-Pratf, M.
4275b746-0450-49ae-9e20-627bc7aea20d
Blasi, F.
f8ef132a-c160-43a2-bf60-a73ac9d4493d
Little, P.
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Verheij, T.
cc355b92-ba85-4102-98a0-cee55f0504f6
Molstad, S.
3f842576-48e7-4adb-8619-64d3b21e76ed
Godycki-Cwirko, M.
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Edwards, P.
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Almirall, J.
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Torres, A.
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Rautakorpi, U-M.
0529762f-5931-4461-9166-2be4b125f851
Nuttall, J.
b5ae8614-d0fa-4488-80f6-33593bb48129
Goossens, H.
533640f7-b568-4d95-a7c1-28158d154ba8
Coenen, S.
9afe2a52-9f4f-45bb-b8e5-c6ee3eeb3498

Butler, C.C., Kelly, M.J., Hood, K., Schaberg, T., Melbye, H., Serra-Pratf, M., Blasi, F., Little, P., Verheij, T., Molstad, S., Godycki-Cwirko, M., Edwards, P., Almirall, J., Torres, A., Rautakorpi, U-M., Nuttall, J., Goossens, H. and Coenen, S. (2011) Antibiotic prescribing for discoloured sputum in acute cough/LRTI. European Respiratory Journal. (doi:10.1183/09031936.00133910).

Record type: Article

Abstract

We investigated whether discoloured sputum and feeling unwell is associated with antibiotic prescribing and benefit from antibiotic treatment for acute cough/lower respiratory tract infection in a prospective study of 3402 adults. in 13 countries.

A two-level model investigated the association between producing discoloured sputum or feeling generally unwell and an antibiotic prescription. A three-level model investigated the association between an antibiotic prescription and symptom resolution.

Patients producing discoloured sputum were prescribed antibiotics more frequently than those not producing sputum (OR: 3.2, 95% CI: [2.1, 5.0]), unlike those producing clear/white sputum (OR: 0.95, 95% CI: [0.61,1.48]). Antibiotic prescribing was not associated with greater rate or magnitude of symptoms score resolution (as measured by 13 item scale completed by patients each day) among those who: produced yellow (Coefficient: 0.00, p-value: 0.68) or green sputum (Coefficient: ?0.01, p-value: 0.11); reported any of three categories of feeling unwell; produced discoloured sputum and felt generally unwell (Coefficient: ?0.01, p-value: 0.19).

Adults with acute cough/LRTI presenting in primary care with discoloured sputum were prescribed antibiotics more often compared to those not producing sputum. Sputum colour, alone or together with feeling generally unwell was not associated with recovery or benefit from antibiotic treatment.

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More information

Published date: 15 March 2011
Keywords: acute cough, antibiotic resistance, antibiotic treatment, lower respiratory tract infection, primary care sputum
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 182331
URI: https://eprints.soton.ac.uk/id/eprint/182331
ISSN: 0903-1936
PURE UUID: c6f8a28f-d270-4659-acbe-4c9a05cf68aa

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Date deposited: 27 Apr 2011 13:33
Last modified: 18 Jul 2017 11:57

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Contributors

Author: C.C. Butler
Author: M.J. Kelly
Author: K. Hood
Author: T. Schaberg
Author: H. Melbye
Author: M. Serra-Pratf
Author: F. Blasi
Author: P. Little
Author: T. Verheij
Author: S. Molstad
Author: M. Godycki-Cwirko
Author: P. Edwards
Author: J. Almirall
Author: A. Torres
Author: U-M. Rautakorpi
Author: J. Nuttall
Author: H. Goossens
Author: S. Coenen

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