An analysis of decisions by European general practitioners to admit to hospital patients with lower respiratory tract infections. The European Study Group of Community Acquired Pneumonia (ESOCAP) of the European Respiratory Society.

Schaberg, T.; Gialdroni-Grassi, G; Huchon, G; Léophonte, P.; Manresa, F.; Woodhead, Mark

doi:10.1136/thx.51.10.1017

Cited by 34 publications

(25 citation statements)

References 20 publications

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“…This has already been reported in the study of MACFARLANE et al [10]. Few patients included in the study were admitted to hospital, as was the case in the report by SCHABERG et al [12]. Therefore, a preliminary conclusion from this study is the predominantly benign nature of the cases observed.…”

Section: Discussionsupporting

confidence: 47%

Management of lower respiratory tract infections by French general practitioners: the AIR II study

Péray¹,

Poirier²,

Romand³

et al. 2002

Eur Respir J

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The Analyse Infections Respiratoires (AIR) II study is a prospective, multicentre survey of the management of lower respiratory tract infections in patients aged 15-65 yrs by general practitioners (GPs) in France.To obtain real-time data recording, practitioners were required to submit an anonymous copy of their drug prescriptions. They were then interviewed over the telephone about the patients9 sociodemographic data, signs and symptoms, as well as their presumptive diagnosis and the investigations they had decided upon.GPs (n=3,144) reported 5,469 evaluable cases. Pneumonia accounted for 9.6% of diagnoses, acute exacerbations of chronic bronchitis 14.9% and acute bronchitis 72.5%. The symptomatology covered an extremely wide range of clinical features, which, although statistically different in terms of incidence, overlapped to a large extent across diagnoses. By contrast, hospitalization, investigations or referral to a specialist were much more prevalent in pneumonia, although still very infrequent in general terms (0.5, 1.2 and 10.8%, respectively). Antibiotics were prescribed in 96.5% of patients, with minor differences between diagnoses. However, other medications such as nonsteroid, anti-inflammatory drugs, steroids, nonspecific antitussives and bronchial liquefiers accounted for two-thirds of the prescriptions.This study demonstrates the lower respiratory tract infections encountered by general practitioners are usually mild. However, antibiotic prescription was more systematic than in previous studies and the prescription of nonspecific symptomatic treatments was twice as frequent. General practitioners did not perform additional examinations or refer on a regular basis. There was a high prescription rate for symptomatic treatment.

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Section: Discussionsupporting

confidence: 47%

Management of lower respiratory tract infections by French general practitioners: the AIR II study

Péray¹,

Poirier²,

Romand³

et al. 2002

Eur Respir J

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“…[4][5][6] The occurrence of ADRs related to INH, especially hepatotoxicity, has been well characterized. 7 The incidence of INH-induced hepatotoxicity ranges from 1 to 36%, depending on different regimens, the population being treated and the definition of hepatic injury used. 8,9 Alcohol consumption, presence of HIV, advanced age and chronic liver disease have been reported to increase the risk of INH-induced hepatotoxicity.…”

Section: Introductionmentioning

confidence: 99%

Genetic variation in carboxylesterase genes and susceptibility to isoniazid-induced hepatotoxicity

et al. 2010

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Treatment of latent tuberculosis infection (LTBI) generally includes isoniazid (INH), a drug that can cause serious hepatotoxicity. Carboxylesterases (CES) are important in the metabolism of a variety of substrates, including xenobiotics. We hypothesized that genetic variation in CES genes expressed in the liver could affect INH-induced hepatotoxicity. Three CES genes are known to be expressed in human liver: CES1, CES2 and CES4. Our aim was to systematically characterize genetic variation in these novel candidate genes and test whether it is associated with this adverse drug reaction. As part of a pilot study, 170 subjects with LTBI who received only INH were recruited, including 23 cases with hepatotoxicity and 147 controls. All exons and the promoters of CES1, CES2 and CES4 were bidirectionally sequenced. A large polymorphic deletion was found to encompass exons 2 to 6 of CES4. No significant association was found. Eleven single-nucleotide polymorphisms (SNPs) in CES1 were in high linkage disequilibrium with each other. One of these SNPs, C(À2)G, alters the translation initiation sequence of CES1 and represents a candidate functional polymorphism. Replication of this possible association in a larger sample set and functional studies will be necessary to determine if this CES1 variant has a role in INH-induced hepatotoxicity.

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“…However, severity assessment of CAP requires a triaging tool that is applicable in outpatients as well. This is particularly important in view of the fact that, in Europe, 15-51% of patients with CAP are hospitalised, possibly imposing considerably high loads of unnecessary costs [17,18]. New data from three large prospective trials are now available.…”

mentioning

confidence: 99%

Assessment of pneumonia severity: a European perspective

Ewig¹

2006

Eur Respir J

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An analysis of decisions by European general practitioners to admit to hospital patients with lower respiratory tract infections. The European Study Group of Community Acquired Pneumonia (ESOCAP) of the European Respiratory Society.

Abstract: Background -The purpose of this study

Cited by 34 publications

References 20 publications

Management of lower respiratory tract infections by French general practitioners: the AIR II study

Management of lower respiratory tract infections by French general practitioners: the AIR II study

Genetic variation in carboxylesterase genes and susceptibility to isoniazid-induced hepatotoxicity

Assessment of pneumonia severity: a European perspective

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