Antibiotic prescribing and outcomes of lower respiratory tract infection in UK primary care. Winchester, C. C., Macfarlane, T. V., Thomas, M., & Price, D. Chest, 135(5):1163--1172, May, 2009. doi abstract bibtex BACKGROUND: Lower respiratory tract infection (LRTI) is common in the community and may result in hospitalization or death. This observational study aimed to investigate the role of antibiotics in the management of LRTI in the primary care setting in the United Kingdom. METHODS: Patients receiving a first diagnosis of LRTI during 2004 and satisfying inclusion and data quality criteria were identified in the General Practice Research Database. Factors associated with respiratory infection-related hospital admissions and death in the 3 months following the initial diagnosis were identified using Cox proportional hazards regression. RESULTS: Antibiotic prescribing on the day of diagnosis was associated with a decreased rate of respiratory infection-related hospital admission (hazard ratio [HR], 0.73; 95% confidence interval [CI], 0.58 to 0.92), while antibiotic prescribing in the previous 7 days (HR, 1.92; 95% CI, 1.24 to 2.96) and prior referral or hospitalization (HR, 1.48; 95% CI, 1.20 to 1.83) were associated with an increased risk of hospital admission. Female sex (HR, 0.73; 95% CI, 0.64 to 0.84), allergic rhinitis (HR, 0.48; 95% CI, 0.27 to 0.83), influenza vaccination (HR, 0.75; 95% CI, 0.65 to 0.87), prior inhaled corticosteroid use (HR, 0.63; 95% CI, 0.52 to 0.76), and antibiotic prescription on the day of diagnosis (HR, 0.31; 95% CI, 0.26 to 0.37) were associated with decreased respiratory infection-related mortality, while a Charlson comorbidity index of \textgreateror= 2 (HR, 2.24; 95% CI, 1.72 to 2.92), antibiotic prescription in the previous 7 days (HR, 1.56; 95% CI, 1.20 to 2.03), and frequent consultation (HR, 1.62; 95% CI, 1.09 to 2.40) were associated with increased mortality. CONCLUSIONS: Antibiotic prescribing on the day of LRTI diagnosis was associated with reductions in hospital admissions and mortality related to respiratory infection. Antibiotics may help to prevent adverse outcomes for some patients with LRTI.
@article{winchester_antibiotic_2009,
title = {Antibiotic prescribing and outcomes of lower respiratory tract infection in {UK} primary care},
volume = {135},
issn = {1931-3543},
doi = {10.1378/chest.07-2940},
abstract = {BACKGROUND: Lower respiratory tract infection (LRTI) is common in the community and may result in hospitalization or death. This observational study aimed to investigate the role of antibiotics in the management of LRTI in the primary care setting in the United Kingdom.
METHODS: Patients receiving a first diagnosis of LRTI during 2004 and satisfying inclusion and data quality criteria were identified in the General Practice Research Database. Factors associated with respiratory infection-related hospital admissions and death in the 3 months following the initial diagnosis were identified using Cox proportional hazards regression.
RESULTS: Antibiotic prescribing on the day of diagnosis was associated with a decreased rate of respiratory infection-related hospital admission (hazard ratio [HR], 0.73; 95\% confidence interval [CI], 0.58 to 0.92), while antibiotic prescribing in the previous 7 days (HR, 1.92; 95\% CI, 1.24 to 2.96) and prior referral or hospitalization (HR, 1.48; 95\% CI, 1.20 to 1.83) were associated with an increased risk of hospital admission. Female sex (HR, 0.73; 95\% CI, 0.64 to 0.84), allergic rhinitis (HR, 0.48; 95\% CI, 0.27 to 0.83), influenza vaccination (HR, 0.75; 95\% CI, 0.65 to 0.87), prior inhaled corticosteroid use (HR, 0.63; 95\% CI, 0.52 to 0.76), and antibiotic prescription on the day of diagnosis (HR, 0.31; 95\% CI, 0.26 to 0.37) were associated with decreased respiratory infection-related mortality, while a Charlson comorbidity index of {\textgreater}or= 2 (HR, 2.24; 95\% CI, 1.72 to 2.92), antibiotic prescription in the previous 7 days (HR, 1.56; 95\% CI, 1.20 to 2.03), and frequent consultation (HR, 1.62; 95\% CI, 1.09 to 2.40) were associated with increased mortality.
CONCLUSIONS: Antibiotic prescribing on the day of LRTI diagnosis was associated with reductions in hospital admissions and mortality related to respiratory infection. Antibiotics may help to prevent adverse outcomes for some patients with LRTI.},
language = {eng},
number = {5},
journal = {Chest},
author = {Winchester, Christopher C. and Macfarlane, Tatiana V. and Thomas, Mike and Price, David},
month = may,
year = {2009},
pmid = {19420194},
keywords = {Adolescent, Adult, Aged, Aged, 80 and over, Anti-Bacterial Agents, Body Mass Index, Child, Child, Preschool, Comorbidity, Drug Utilization, Female, Great Britain, Humans, Infant, Life Style, Male, Middle Aged, Physician's Practice Patterns, Pneumonia, Primary Health Care, Prognosis, Proportional Hazards Models, Respiratory Tract Infections, Young Adult},
pages = {1163--1172}
}
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{"_id":"WPrjWGXjuKooGjx6y","bibbaseid":"winchester-macfarlane-thomas-price-antibioticprescribingandoutcomesoflowerrespiratorytractinfectioninukprimarycare-2009","downloads":0,"creationDate":"2017-08-15T09:38:11.271Z","title":"Antibiotic prescribing and outcomes of lower respiratory tract infection in UK primary care","author_short":["Winchester, C. C.","Macfarlane, T. V.","Thomas, M.","Price, D."],"year":2009,"bibtype":"article","biburl":"http://bibbase.org/zotero/veegee78","bibdata":{"bibtype":"article","type":"article","title":"Antibiotic prescribing and outcomes of lower respiratory tract infection in UK primary care","volume":"135","issn":"1931-3543","doi":"10.1378/chest.07-2940","abstract":"BACKGROUND: Lower respiratory tract infection (LRTI) is common in the community and may result in hospitalization or death. This observational study aimed to investigate the role of antibiotics in the management of LRTI in the primary care setting in the United Kingdom. METHODS: Patients receiving a first diagnosis of LRTI during 2004 and satisfying inclusion and data quality criteria were identified in the General Practice Research Database. Factors associated with respiratory infection-related hospital admissions and death in the 3 months following the initial diagnosis were identified using Cox proportional hazards regression. RESULTS: Antibiotic prescribing on the day of diagnosis was associated with a decreased rate of respiratory infection-related hospital admission (hazard ratio [HR], 0.73; 95% confidence interval [CI], 0.58 to 0.92), while antibiotic prescribing in the previous 7 days (HR, 1.92; 95% CI, 1.24 to 2.96) and prior referral or hospitalization (HR, 1.48; 95% CI, 1.20 to 1.83) were associated with an increased risk of hospital admission. Female sex (HR, 0.73; 95% CI, 0.64 to 0.84), allergic rhinitis (HR, 0.48; 95% CI, 0.27 to 0.83), influenza vaccination (HR, 0.75; 95% CI, 0.65 to 0.87), prior inhaled corticosteroid use (HR, 0.63; 95% CI, 0.52 to 0.76), and antibiotic prescription on the day of diagnosis (HR, 0.31; 95% CI, 0.26 to 0.37) were associated with decreased respiratory infection-related mortality, while a Charlson comorbidity index of \\textgreateror= 2 (HR, 2.24; 95% CI, 1.72 to 2.92), antibiotic prescription in the previous 7 days (HR, 1.56; 95% CI, 1.20 to 2.03), and frequent consultation (HR, 1.62; 95% CI, 1.09 to 2.40) were associated with increased mortality. CONCLUSIONS: Antibiotic prescribing on the day of LRTI diagnosis was associated with reductions in hospital admissions and mortality related to respiratory infection. Antibiotics may help to prevent adverse outcomes for some patients with LRTI.","language":"eng","number":"5","journal":"Chest","author":[{"propositions":[],"lastnames":["Winchester"],"firstnames":["Christopher","C."],"suffixes":[]},{"propositions":[],"lastnames":["Macfarlane"],"firstnames":["Tatiana","V."],"suffixes":[]},{"propositions":[],"lastnames":["Thomas"],"firstnames":["Mike"],"suffixes":[]},{"propositions":[],"lastnames":["Price"],"firstnames":["David"],"suffixes":[]}],"month":"May","year":"2009","pmid":"19420194","keywords":"Adolescent, Adult, Aged, Aged, 80 and over, Anti-Bacterial Agents, Body Mass Index, Child, Child, Preschool, Comorbidity, Drug Utilization, Female, Great Britain, Humans, Infant, Life Style, Male, Middle Aged, Physician's Practice Patterns, Pneumonia, Primary Health Care, Prognosis, Proportional Hazards Models, Respiratory Tract Infections, Young Adult","pages":"1163--1172","bibtex":"@article{winchester_antibiotic_2009,\n\ttitle = {Antibiotic prescribing and outcomes of lower respiratory tract infection in {UK} primary care},\n\tvolume = {135},\n\tissn = {1931-3543},\n\tdoi = {10.1378/chest.07-2940},\n\tabstract = {BACKGROUND: Lower respiratory tract infection (LRTI) is common in the community and may result in hospitalization or death. This observational study aimed to investigate the role of antibiotics in the management of LRTI in the primary care setting in the United Kingdom.\nMETHODS: Patients receiving a first diagnosis of LRTI during 2004 and satisfying inclusion and data quality criteria were identified in the General Practice Research Database. Factors associated with respiratory infection-related hospital admissions and death in the 3 months following the initial diagnosis were identified using Cox proportional hazards regression.\nRESULTS: Antibiotic prescribing on the day of diagnosis was associated with a decreased rate of respiratory infection-related hospital admission (hazard ratio [HR], 0.73; 95\\% confidence interval [CI], 0.58 to 0.92), while antibiotic prescribing in the previous 7 days (HR, 1.92; 95\\% CI, 1.24 to 2.96) and prior referral or hospitalization (HR, 1.48; 95\\% CI, 1.20 to 1.83) were associated with an increased risk of hospital admission. Female sex (HR, 0.73; 95\\% CI, 0.64 to 0.84), allergic rhinitis (HR, 0.48; 95\\% CI, 0.27 to 0.83), influenza vaccination (HR, 0.75; 95\\% CI, 0.65 to 0.87), prior inhaled corticosteroid use (HR, 0.63; 95\\% CI, 0.52 to 0.76), and antibiotic prescription on the day of diagnosis (HR, 0.31; 95\\% CI, 0.26 to 0.37) were associated with decreased respiratory infection-related mortality, while a Charlson comorbidity index of {\\textgreater}or= 2 (HR, 2.24; 95\\% CI, 1.72 to 2.92), antibiotic prescription in the previous 7 days (HR, 1.56; 95\\% CI, 1.20 to 2.03), and frequent consultation (HR, 1.62; 95\\% CI, 1.09 to 2.40) were associated with increased mortality.\nCONCLUSIONS: Antibiotic prescribing on the day of LRTI diagnosis was associated with reductions in hospital admissions and mortality related to respiratory infection. Antibiotics may help to prevent adverse outcomes for some patients with LRTI.},\n\tlanguage = {eng},\n\tnumber = {5},\n\tjournal = {Chest},\n\tauthor = {Winchester, Christopher C. and Macfarlane, Tatiana V. and Thomas, Mike and Price, David},\n\tmonth = may,\n\tyear = {2009},\n\tpmid = {19420194},\n\tkeywords = {Adolescent, Adult, Aged, Aged, 80 and over, Anti-Bacterial Agents, Body Mass Index, Child, Child, Preschool, Comorbidity, Drug Utilization, Female, Great Britain, Humans, Infant, Life Style, Male, Middle Aged, Physician's Practice Patterns, Pneumonia, Primary Health Care, Prognosis, Proportional Hazards Models, Respiratory Tract Infections, Young Adult},\n\tpages = {1163--1172}\n}\n\n","author_short":["Winchester, C. C.","Macfarlane, T. 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