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Reducing uncertainty in managing respiratory tract infections in primary care

Reducing uncertainty in managing respiratory tract infections in primary care
Reducing uncertainty in managing respiratory tract infections in primary care
Respiratory tract infections (RTIs) remain the commonest reason for acute consultations in primary care in resource-rich countries. Their spectrum and severity has changed from the time that antibiotics were discovered, largely from improvements in the socioeconomic determinants of health as well as vaccination. The benefits from antibiotic treatment for common RTIs have been shown to be largely overstated. Nevertheless, serious infections do occur. Currently, no clinical features or diagnostic test, alone or in combination, adequately determine diagnosis, aetiology, prognosis, or response to treatment. This narrative review focuses on emerging evidence aimed at helping clinicians reduce and manage uncertainty in treating RTIs. Consultation rate and prescribing rate trends are described, evidence of increasing rates of complications are discussed, and studies and the association with antibiotic prescribing are examined. Methods of improving diagnosis and identifying those patients who are at increased risk of complications from RTIs, using clinical scoring systems, biomarkers, and point of care tests are also discussed. The evidence for alternative management options for RTIs are summarised and the methods for changing public and clinicians' beliefs about antibiotics, including ways in which we can improve clinician-patient communication skills for management of RTIs, are described.
anti-bacterial agents, cough, primary health care, respiratory tract infections
e466-e475
Stanton, Naomi
3228b8ba-3f68-45a2-8dd3-accb6a5eef13
Francis, Nicholas Andrew
9b610883-605c-4fee-871d-defaa86ccf8e
Butler, Christopher Collett
d2f9102c-54c2-4570-be4e-32324c8c8f1d
Stanton, Naomi
3228b8ba-3f68-45a2-8dd3-accb6a5eef13
Francis, Nicholas Andrew
9b610883-605c-4fee-871d-defaa86ccf8e
Butler, Christopher Collett
d2f9102c-54c2-4570-be4e-32324c8c8f1d

Stanton, Naomi, Francis, Nicholas Andrew and Butler, Christopher Collett (2010) Reducing uncertainty in managing respiratory tract infections in primary care. British Journal of General Practice, 60 (581), e466-e475. (doi:10.3399/bjgp10X544104).

Record type: Article

Abstract

Respiratory tract infections (RTIs) remain the commonest reason for acute consultations in primary care in resource-rich countries. Their spectrum and severity has changed from the time that antibiotics were discovered, largely from improvements in the socioeconomic determinants of health as well as vaccination. The benefits from antibiotic treatment for common RTIs have been shown to be largely overstated. Nevertheless, serious infections do occur. Currently, no clinical features or diagnostic test, alone or in combination, adequately determine diagnosis, aetiology, prognosis, or response to treatment. This narrative review focuses on emerging evidence aimed at helping clinicians reduce and manage uncertainty in treating RTIs. Consultation rate and prescribing rate trends are described, evidence of increasing rates of complications are discussed, and studies and the association with antibiotic prescribing are examined. Methods of improving diagnosis and identifying those patients who are at increased risk of complications from RTIs, using clinical scoring systems, biomarkers, and point of care tests are also discussed. The evidence for alternative management options for RTIs are summarised and the methods for changing public and clinicians' beliefs about antibiotics, including ways in which we can improve clinician-patient communication skills for management of RTIs, are described.

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More information

Published date: 1 December 2010
Keywords: anti-bacterial agents, cough, primary health care, respiratory tract infections

Identifiers

Local EPrints ID: 436269
URI: http://eprints.soton.ac.uk/id/eprint/436269
PURE UUID: e68aedd0-2b89-4700-9240-ddf45f07463d
ORCID for Nicholas Andrew Francis: ORCID iD orcid.org/0000-0001-8939-7312

Catalogue record

Date deposited: 05 Dec 2019 17:30
Last modified: 17 Mar 2024 03:58

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Contributors

Author: Naomi Stanton
Author: Christopher Collett Butler

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