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Clinical presentation, microbiological aetiology and disease course in patients with flu-like illness: a post hoc analysis of randomised controlled trial data
TJ. Verheij, D. Cianci, AW. van der Velden, CC. Butler, E. Bongard, S. Coenen, A. Colliers, NA. Francis, P. Little, M. Godycki-Cwirko, C. Llor, S. Chlabicz, C. Lionis, PD. Sundvall, L. Bjerrum, A. De Sutter, R. Aabenhus, NJ. Harbin, M. Lindbæk,...
Jazyk angličtina Země Velká Británie
Typ dokumentu časopisecké články, randomizované kontrolované studie, práce podpořená grantem
NLK
Free Medical Journals
od 1990 do Před 1 rokem
PubMed Central
od 1990 do Před 1 rokem
Europe PubMed Central
od 1990 do Před 1 rokem
Open Access Digital Library
od 1953-09-01
Medline Complete (EBSCOhost)
od 2013-03-01
PubMed
34990385
DOI
10.3399/bjgp.2021.0344
Knihovny.cz E-zdroje
- MeSH
- COVID-19 * MeSH
- dítě MeSH
- dospělí MeSH
- infekce dýchací soustavy * diagnóza farmakoterapie mikrobiologie MeSH
- lidé MeSH
- pandemie MeSH
- SARS-CoV-2 MeSH
- virové nemoci * komplikace diagnóza epidemiologie MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- randomizované kontrolované studie MeSH
BACKGROUND: There is little evidence about the relationship between aetiology, illness severity, and clinical course of respiratory tract infections (RTIs) in primary care. Understanding these associations would aid in the development of effective management strategies for these infections. AIM: To investigate whether clinical presentation and illness course differ between RTIs where a viral pathogen was detected and those where a potential bacterial pathogen was found. DESIGN AND SETTING: Post hoc analysis of data from a pragmatic randomised trial on the effects of oseltamivir in patients with flu-like illness in primary care (n = 3266) in 15 European countries. METHOD: Patient characteristics and their signs and symptoms of disease were registered at baseline. Nasopharyngeal (adults) or nasal and pharyngeal (children) swabs were taken for polymerase chain reaction analysis. Patients were followed up until 28 days after inclusion. Regression models and Kaplan-Meier curves were used to analyse the relationship between aetiology, clinical presentation at baseline, and course of disease including complications. RESULTS: Except for a less prominent congested nose (odds ratio [OR] 0.55, 95% confidence interval [CI] = 0.35 to 0.86) and acute cough (OR 0.42, 95% CI = 0.27 to 0.65) in patients with flu-like illness in whom a possible bacterial pathogen was isolated, there were no clear clinical differences in presentations between those with a possible bacterial aetiology compared with those with a viral aetiology. Also, course of disease and complications were not related to aetiology. CONCLUSION: Given current available microbiological tests and antimicrobial treatments, and outside pandemics such as COVID-19, microbiological testing in primary care patients with flu-like illness seems to have limited value. A wait-and-see policy in most of these patients with flu-like illness seems the best option.
Clinic of Social and Family Medicine University of Crete School of Medicine Heraklion Greece
Départment de Santé Publique Université Côte d'Azur Faculté de Médecine Nice France
Department of Family Medicine Medical University of Bialystok Bialystok Poland
Department of General Practice Charles University Prague Czech Republic
Drug Research Center Balatonfüred Hungary
Institute for Clinical Epidemiology and Biostatistics University Hospital Basel Basel Switzerland
JSC Mano Seimos Gydytojas Klaipeda Lithuania
Nuffield Department of Primary Care University of Oxford Medical Sciences Division Oxford UK
Primary Care and Population Sciences University of Southampton Southampton UK
Research and Development Primary Health Care Västra Götalandsregionen University of Gothenburg
Royal College of Surgeons in Ireland Dublin Ireland
University Institute in Primary Care Research Jordi Gol Via Roma Health Centre Barcelona Spain
Citace poskytuje Crossref.org
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