Use of antibiotics and other treatments in Chinese adults with acute cough: an online survey
Use of antibiotics and other treatments in Chinese adults with acute cough: an online survey
Background: this study aimed to identify use of various treatments and their association with the use of antibiotics and patient reported clinical recovery in Chinese adults with acute cough.
Methods: an online survey recruiting people who had recently experienced cough was conducted. Their sociodemographic, clinical characteristics, treatments received and their perceived changes in symptoms were collected. Factors influencing avoidance of antibiotics and improvement in symptoms were explored.
Results: a total of 22,787 adults with recent acute cough completed the questionnaire, covering all 34 province-level administrative units in China. Most respondents were male (68.0%), young (89.4%, aged 18–45), educated to university/degree or postgraduate level (44.6%), with a median cough severity of 6/10 on a numerical rating scale. Nearly half of the participants (46.4%) reported using antibiotics, among which 93.1% were for presumed upper respiratory tract infections (URTIs). Pharmacies (48.8%) were the most common source of antibiotics. Fewer patients took antibiotics after taking CHM (14.9%), compared to those who started with home remedies (18.0%), or allopathic non-antibiotic medication (25.0%). Antibiotics, allopathic non-antibiotic medications, CHM and home remedies were all perceived beneficial in relieving cough.
Conclusions: Chinese adult responders report use of a considerable variety of treatments alone or in combination for acute cough. Patient-reported clinical recovery was similar regardless of treatment. There is likely a high proportion of inappropriate use of antibiotics for treatment of simple acute cough. As the majority of respondents did not use antibiotics as a first-line, and use of CHM was associated with relief of cough symptoms and reduction in the use of antibiotics, this presents an important opportunity for prudent antibiotic stewardship in China.
Acute cough, Antibiotics, Chinese herbal medicine, Respiratory tract infection, Survey
Hu, Xiao-Yang
65904b24-3775-4b14-9532-eb703a056655
Xia, Ru-Yu
93e6664d-40f0-43e8-b156-e0d037404694
Moore, Michael
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Stuart, Beth
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Wen, Ling-Zi
356fb763-7fb3-4bc8-b34c-78ee99d139a5
Graz, Bertrand
33383bb4-8763-40bc-8e09-a045934a536e
Lai, Lily
4ad55f3d-3e0c-4faa-a981-cbbbb4319811
Liu, Jian-Ping
ab58e381-fd47-404c-ba28-9dfc6423002f
Fei, Yu-Tong
4aed6774-69e6-423c-80a4-e49e9ee65f40
Willcox, Merlin
dad5b622-9ac2-417d-9b2e-aad41b64ffea
6 January 2023
Hu, Xiao-Yang
65904b24-3775-4b14-9532-eb703a056655
Xia, Ru-Yu
93e6664d-40f0-43e8-b156-e0d037404694
Moore, Michael
1be81dad-7120-45f0-bbed-f3b0cc0cfe99
Stuart, Beth
626862fc-892b-4f6d-9cbb-7a8d7172b209
Wen, Ling-Zi
356fb763-7fb3-4bc8-b34c-78ee99d139a5
Graz, Bertrand
33383bb4-8763-40bc-8e09-a045934a536e
Lai, Lily
4ad55f3d-3e0c-4faa-a981-cbbbb4319811
Liu, Jian-Ping
ab58e381-fd47-404c-ba28-9dfc6423002f
Fei, Yu-Tong
4aed6774-69e6-423c-80a4-e49e9ee65f40
Willcox, Merlin
dad5b622-9ac2-417d-9b2e-aad41b64ffea
Hu, Xiao-Yang, Xia, Ru-Yu, Moore, Michael, Stuart, Beth, Wen, Ling-Zi, Graz, Bertrand, Lai, Lily, Liu, Jian-Ping, Fei, Yu-Tong and Willcox, Merlin
(2023)
Use of antibiotics and other treatments in Chinese adults with acute cough: an online survey.
Integrative Medicine Research, 12 (1), [100920].
(doi:10.1016/j.imr.2022.100920).
Abstract
Background: this study aimed to identify use of various treatments and their association with the use of antibiotics and patient reported clinical recovery in Chinese adults with acute cough.
Methods: an online survey recruiting people who had recently experienced cough was conducted. Their sociodemographic, clinical characteristics, treatments received and their perceived changes in symptoms were collected. Factors influencing avoidance of antibiotics and improvement in symptoms were explored.
Results: a total of 22,787 adults with recent acute cough completed the questionnaire, covering all 34 province-level administrative units in China. Most respondents were male (68.0%), young (89.4%, aged 18–45), educated to university/degree or postgraduate level (44.6%), with a median cough severity of 6/10 on a numerical rating scale. Nearly half of the participants (46.4%) reported using antibiotics, among which 93.1% were for presumed upper respiratory tract infections (URTIs). Pharmacies (48.8%) were the most common source of antibiotics. Fewer patients took antibiotics after taking CHM (14.9%), compared to those who started with home remedies (18.0%), or allopathic non-antibiotic medication (25.0%). Antibiotics, allopathic non-antibiotic medications, CHM and home remedies were all perceived beneficial in relieving cough.
Conclusions: Chinese adult responders report use of a considerable variety of treatments alone or in combination for acute cough. Patient-reported clinical recovery was similar regardless of treatment. There is likely a high proportion of inappropriate use of antibiotics for treatment of simple acute cough. As the majority of respondents did not use antibiotics as a first-line, and use of CHM was associated with relief of cough symptoms and reduction in the use of antibiotics, this presents an important opportunity for prudent antibiotic stewardship in China.
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More information
Accepted/In Press date: 19 December 2022
e-pub ahead of print date: 23 December 2022
Published date: 6 January 2023
Additional Information:
Funding Information:
The Global Network for Anti-Microbial Resistance and Infection Prevention (Global-NAMRIP) awarded pump-priming funding to support this research through the EPSRC (Grant EP/MO27260/1 ). XYH was funded by the National Institute of Health Research ( NIHR ) School for Primary Care Research (SPCR). MLW was funded by the National Institute of Health Research ( NIHR ), (Grant CL-2016–26–005 ).
Funding Information:
A warm thank you to all networks that contributed to the dissemination of the survey and to the participants who gave up their time to complete the survey. Conceptualization: XYH, MW, RYX, TYF; Methodology: All; Formal analysis: RYX; Investigation: RYX, TYF, XYH, ML; Resources: YTF, XYH, RYX, JPL, LZW; Data curation: RYX, YTF; Writing: XYH; Review & Editing: All; Visualization: XYH; Supervision: MW, YTF; Project administration: RYX; Funding acquisition: XYH, MW. All authors have read and agreed to the published version of the manuscript. There is no professional writer involved. The authors declare no conflict of interest. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results. The Global Network for Anti-Microbial Resistance and Infection Prevention (Global-NAMRIP) awarded pump-priming funding to support this research through the EPSRC (Grant EP/MO27260/1). XYH was funded by the National Institute of Health Research (NIHR) School for Primary Care Research (SPCR). MLW was funded by the National Institute of Health Research (NIHR), (Grant CL-2016–26–005). Ethical approval was sought from the University of Southampton ethics committee (ERGO 31,602) and the Beijing University of Chinese Medicine ethics committee (2018BZHYLL0101). The data that support the findings of this study are available within the article and its supplementary material, or are available from the corresponding author upon reasonable request.
Keywords:
Acute cough, Antibiotics, Chinese herbal medicine, Respiratory tract infection, Survey
Identifiers
Local EPrints ID: 474208
URI: http://eprints.soton.ac.uk/id/eprint/474208
ISSN: 2213-4220
PURE UUID: c413c8e0-0af8-4d21-8a93-0dbf3d0435ad
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Date deposited: 15 Feb 2023 17:47
Last modified: 18 Mar 2024 03:39
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Contributors
Author:
Ru-Yu Xia
Author:
Ling-Zi Wen
Author:
Bertrand Graz
Author:
Jian-Ping Liu
Author:
Yu-Tong Fei
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