Antibiotic prescribing for self limiting respiratory tract infections in primary care: summary of NICE guidance

Tan, Toni; Little, Paul; Stokes, Tim

doi:10.1136/bmj.a437

Cited by 118 publications

(83 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Clinical guidelines do not support routine antibiotic treatment for patients with RTIs. 4 Diagnostic uncertainty often leads to increased inappropriate antibiotic prescribing. 5,6 C-reactive protein (CRP) is an acknowledged biomarker to diagnose bacterial infection.…”

Section: Introductionmentioning

confidence: 99%

Association between point-of-care CRP testing and antibiotic prescribing in respiratory tract infections: a systematic review and meta-analysis of primary care studies

Huang¹,

Chen²,

Wu³

et al. 2013

Br J Gen Pract

105

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 99%

Association between point-of-care CRP testing and antibiotic prescribing in respiratory tract infections: a systematic review and meta-analysis of primary care studies

Huang¹,

Chen²,

Wu³

et al. 2013

Br J Gen Pract

105

View full text Add to dashboard Cite

show abstract

“…Bilateral AOM is nowadays considered more severe than unilateral AOM, and more active antimicrobial treatment and/or follow-up of bilateral AOM is recommended by the guidelines of, for example, the Netherlands, England, Italy, and Sweden, [2][3][4][5] which are largely based on the meta-analysis of Rovers et al 6 According to their results, young children with bilateral AOM benefit more from antimicrobial treatment than those with unilateral AOM. Nevertheless, the symptoms and signs of bilateral and unilateral AOM at the time of diagnosis have previously been compared by only 2 study groups.…”

Section: Discussionmentioning

confidence: 99%

“…Third, we asked parents to assess their child' s overall condition (range, 0-7) at its worst within the preceding 24 hours and at study clinic, by the AOM-faces scale, which was developed by Friedman et al 13 Fourth, we used the modified AOM total severity index (AOM-Si) as suggested by McCormick et al 14 to determine the severity of AOM. We calculated the AOM-Si score (range, [1][2][3][4][5][6][7][8][9][10][11][12][13][14] by summing up the highest OS-8 score and the highest AOM-faces scale at its worst within 24 hours. Fifth, based on our symptom questionnaire, we calculated the AOM severity of symptom scale (AOM-SOS; version 3.0), which Shaikh et al 15 created.…”

Section: Methodsmentioning

confidence: 99%

Symptoms and Otoscopic Signs in Bilateral and Unilateral Acute Otitis Media

et al. 2013

View full text Add to dashboard Cite

WHAT'S KNOWN ON THIS SUBJECT: Bilateral acute otitis media (AOM) is considered more severe than unilateral AOM, and several guidelines recommend more active management of bilateral AOM. However, severity of symptoms and otoscopic signs of bilateral and unilateral AOM have previously not been comprehensively studied.WHAT THIS STUDY ADDS: Bilateral AOM seems to be clinically only a slightly more severe illness than unilateral AOM. When assessing AOM severity, bilaterality should not be used as a determining criterion; instead, the child' s symptoms together with otoscopic signs should also be acknowledged. abstract OBJECTIVE: Bilateral acute otitis media (AOM) is considered more severe than unilateral AOM, and several guidelines recommend more active treatment and/or follow-up of bilateral AOM. We studied whether bilateral AOM is a clinically more severe illness than unilateral AOM by comparing symptoms and otoscopic signs between bilateral and unilateral AOM. METHODS:Two hundred thirty-two children aged 6 to 35 months diagnosed with AOM were eligible. We surveyed the symptoms with a structured questionnaire and recorded the otoscopic signs systematically.RESULTS: Ninety-eight children had bilateral and 134 children unilateral AOM. Children with bilateral AOM were more often ,24 months than children with unilateral AOM (87% vs 75%; P = .032). Fever ($38°C) occurred in 54% and 36% (P = .006) and severe conjunctivitis in 16% and 44% (P = .047) of children with bilateral and unilateral AOM, respectively. In 15 other symptoms, we found no overall differences even when adjusted with age. We observed the following severe otoscopic signs in the bilateral and unilateral AOM group, respectively: moderate/marked bulging of tympanic membrane (63% and 40%; P = .001), purulent effusion (89% and 71%; P = .001), bulla formation (11% and 10%; P = .707), and hemorrhagic redness of tympanic membrane (7% and 10%; P = .386). CONCLUSIONS:Bilateral AOM seems to be a clinically only slightly more severe illness than unilateral AOM. Therefore, when assessing AOM severity, bilaterality should not be used as a determining criterion; instead, the child' s symptomatic condition together with otoscopic signs should also be taken into consideration.

show abstract

“…В проведенных ран-доминизированных плацебо-контролируемых исследо-ваниях было показано, что назначение антибактериаль-ной терапии не ускоряет выздоровление и не преду-преждает возникновения осложнений, однако повышает риск побочных неблагоприятных эффектов [6,7]. Тактика врача при постановке диагноза ОРВИ включает обяза-тельное разъяснение пациенту, что беспокоящее его заболевание вирусной природы, доброкачественного течения, симптомы могут продолжаться, постепенно уменьшаясь, до 2 нед.…”

Section: острая респираторная вирусная инфекция (орви)unclassified

“…Тем не менее следует предупредить пациента, что ему следует немедленно повторно обра-титься к врачу в случае, если состояние ухудшится или симптоматика продлится дольше предполагаемого срока выздоровления в 2 нед. [6,7]. Для облегчения общего состояния при ОРВИ назначается симптоматическая терапия.…”

Section: острая респираторная вирусная инфекция (орви)unclassified

Antibiotic Therapy for Acute Upper Respiratory Tract Diseases

Дербенева¹

2017

Med. sov.

View full text Add to dashboard Cite

В статье представлены основные дифференциально-диагностические критерии острой респираторной вирусной инфек-ции, острого тонзиллофарингита и острого риносинусита, приведены различия клинического течения вирусных и бактери-альных форм заболеваний. Обсуждается необходимость и сроки назначения антибактериальной терапии, представлены препараты для стартовой эмпирической терапии этих заболеваний.

show abstract

Antibiotic prescribing for self limiting respiratory tract infections in primary care: summary of NICE guidance

Cited by 118 publications

References 7 publications

Association between point-of-care CRP testing and antibiotic prescribing in respiratory tract infections: a systematic review and meta-analysis of primary care studies

Association between point-of-care CRP testing and antibiotic prescribing in respiratory tract infections: a systematic review and meta-analysis of primary care studies

Symptoms and Otoscopic Signs in Bilateral and Unilateral Acute Otitis Media

Antibiotic Therapy for Acute Upper Respiratory Tract Diseases

Contact Info

Product

Resources

About