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Bruyndonckx R, Stuart B, Little P, et al. The Effect of Amoxicillin in Adult Patients Presenting to Primary Care with Acute Cough Predicted to Have Pneumonia or a Combined Viral-Bacterial Infection. Antibiotics (Basel). 2021;10(7)doi: 10.3390/antibiotics10070817.
Bruyndonckx, R., Stuart, B., Little, P., Hens, N., Ieven, M., Butler, C. C., Verheij, T. J. M., Goossens, H., Coenen, S., & The Grace Project Group. (2021). The Effect of Amoxicillin in Adult Patients Presenting to Primary Care with Acute Cough Predicted to Have Pneumonia or a Combined Viral-Bacterial Infection. Antibiotics (Basel, Switzerland), 10(7), . https://doi.org/10.3390/antibiotics10070817
Bruyndonckx, Robin, et al. "The Effect of Amoxicillin in Adult Patients Presenting to Primary Care with Acute Cough Predicted to Have Pneumonia or a Combined Viral-Bacterial Infection." Antibiotics (Basel, Switzerland) vol. 10,7 (2021). doi: https://doi.org/10.3390/antibiotics10070817
Bruyndonckx R, Stuart B, Little P, Hens N, Ieven M, Butler CC, Verheij TJM, Goossens H, Coenen S, The Grace Project Group. The Effect of Amoxicillin in Adult Patients Presenting to Primary Care with Acute Cough Predicted to Have Pneumonia or a Combined Viral-Bacterial Infection. Antibiotics (Basel). 2021 Jul 06;10(7). doi: 10.3390/antibiotics10070817. PMID: 34356738; PMCID: PMC8300796.
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Antibiotics (Basel). 2021 Jul 06;10(7). doi: 10.3390/antibiotics10070817.

The Effect of Amoxicillin in Adult Patients Presenting to Primary Care with Acute Cough Predicted to Have Pneumonia or a Combined Viral-Bacterial Infection.

Antibiotics (Basel, Switzerland)

Robin Bruyndonckx, Beth Stuart, Paul Little, Niel Hens, Margareta Ieven, Christopher C Butler, Theo J M Verheij, Herman Goossens, Samuel Coenen, The Grace Project Group

Affiliations

  1. Interuniversity Institute for Biostatistics and Statistical Bioinformatics (I-BIOSTAT), Data Science Institute (DSI), Hasselt University, 3500 Hasselt, Belgium.
  2. Laboratory of Medical Microbiology, Vaccine & Infectious Diseases Institute (VAXINFECTIO), University of Antwerp, 2610 Antwerp, Belgium.
  3. Aldermoor Health Centre, University of Southampton, Southampton SO16 5ST, UK.
  4. Centre for Health Economic Research and Modelling Infectious Diseases (CHERMID), Vaccine & Infectious Disease Institute, University of Antwerp, 2610 Antwerp, Belgium.
  5. Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK.
  6. Julius Centre for Health, Sciences and Primary Care, University Medical Centre Utrecht, 3508 GA Utrecht, The Netherlands.
  7. Centre for General Practice, Department of Family Medicine & Population Health (FAMPOP), University of Antwerp, 2610 Antwerp, Belgium.

PMID: 34356738 PMCID: PMC8300796 DOI: 10.3390/antibiotics10070817

Abstract

While most cases of acute cough are self-limiting, antibiotics are prescribed to over 50%. This proportion is inappropriately high given that benefit from treatment with amoxicillin could only be demonstrated in adults with pneumonia (based on chest radiograph) or combined viral-bacterial infection (based on modern microbiological methodology). As routine use of chest radiographs and microbiological testing is costly, clinical prediction rules could be used to identify these patient subsets. In this secondary analysis of data from a multicentre randomised controlled trial in adults presenting to primary care with acute cough, we used prediction rules for pneumonia or combined infection and assessed the effect of amoxicillin in patients predicted to have pneumonia or combined infection on symptom duration, symptom severity and illness deterioration. In total, 2056 patients that fulfilled all inclusion criteria were randomised, 1035 to amoxicillin, 1021 to placebo. Neither patients with a predicted pneumonia nor patients with a predicted combined infection were significantly more likely to benefit from amoxicillin. While the studied clinical prediction rules may help primary care clinicians to reduce antibiotic prescribing for low-risk patients, they did not identify adult acute cough patients that would benefit from amoxicillin treatment.

Keywords: adults; amoxicillin; benefit of treatment; clinical prediction rule; lower respiratory tract infection; pneumonia; primary care; viral–bacterial infection

References

  1. BMJ. 2009 Jun 23;338:b2242 - PubMed
  2. Eur Respir J. 2013 Sep;42(3):559-63 - PubMed
  3. Lancet Infect Dis. 2013 Feb;13(2):123-9 - PubMed
  4. Eur Respir J. 2016 Jan;47(1):327-30 - PubMed
  5. Clin Microbiol Infect. 2018 Aug;24(8):871-876 - PubMed
  6. Clin Microbiol Infect. 2018 Nov;24(11):1158-1163 - PubMed
  7. J Int Med Res. 2018 Aug;46(8):3337-3357 - PubMed
  8. CMAJ. 2017 Jan 16;189(2):E50-E55 - PubMed
  9. Br J Gen Pract. 2014 Feb;64(619):60-2 - PubMed
  10. BMJ. 2013 Apr 30;346:f2450 - PubMed
  11. Eur Respir J. 2013 Oct;42(4):1076-82 - PubMed
  12. Cancer. 1950 Jan;3(1):32-5 - PubMed
  13. Br J Gen Pract. 2018 May;68(670):e342-e350 - PubMed
  14. Br J Gen Pract. 2014 Feb;64(619):e75-80 - PubMed

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