Fears about complications shouldn't drive antibiotic prescribingOctober 19, 2007Antibiotics are not justified to reduce the risk of complications after upper respiratory tract infection, sore throat, or ear infection, finds a study published on bmj.com today Antibiotics are not justified to reduce the risk of complications after upper respiratory tract infection, sore throat, or ear infection, finds a study published on bmj.com today. But they do substantially cut the risk of pneumonia after chest infection, particularly in elderly people. Most antibiotic prescribing is in primary care, and most of it is for common respiratory tract infections. Guidelines advise against the routine use of antibiotics in patients with upper respiratory tract infection, sore throat, and ear infection, but do recommend them for pneumonia. Although rates of antibiotic prescribing for acute respiratory infections in UK general practice declined by 45% between 1994 and 2000, in 2000 antibiotics were still prescribed to 67% of patients with respiratory infection, including over 90% of those with chest infection, 80% with ear infections, 60% with sore throat, and 47% with upper respiratory tract infections. On the basis of the evidence in this BMJ study, there seems to be a substantial gap between evidence based guidance and general practitioners' prescribing behaviour, say the authors. So, they identified 3.36 million episodes of respiratory tract infection recorded between 1991 and 2001 in the UK General Practice Research Database and determined whether complications were less common in people who were prescribed antibiotics than in those who were not. Risk of serious complications in the month after diagnosis were recorded: mastoiditis (infection of the mastoid bone of the skull) after ear infection, quinsy (an abscess at the back of the throat) after sore throat, and pneumonia after upper respiratory tract infection and chest infection. The number of patients needed to treat to prevent one complication was also recorded. Serious complications were rare after upper respiratory tract infections, sore throat, and ear infection. Antibiotics reduced the risk, but over 4,000 courses were needed to prevent one complication. In contrast, the risk of pneumonia after chest infection was high, particularly in elderly people, and was substantially reduced by antibiotic use. The number needed to treat to prevent one case of pneumonia was 39 for those aged 65 and over and between 96 and 119 in younger age groups. The risks were not appreciably different in smokers, those with chronic respiratory disease, or those with cardiac disease. The authors conclude that general practitioners should not base their prescribing for sore throat, ear infection, or upper respiratory tract infections on a fear of serious complications. However, antibiotic prescribing to reduce the risk of pneumonia after chest infection is justifiable, particularly in elderly patients in whom the risk is highest. This view is reiterated in an accompanying BMJ editorial by researchers at the University of Antwerp, who say that most infections can be managed by watchful waiting. BMJ-British Medical Journal |
|||||||||||||||||||||
| Related Respiratory Tract Current Events and Respiratory Tract News Articles American Dietetic Association Releases Updated Position Paper Promoting and Supporting Breastfeeding The American Dietetic Association has released an updated position paper on breastfeeding that details health benefits for both infants and mothers and encourages promotion of breastfeeding whenever possible. Important new novel 2009 H1N1 flu advisory for cardiopulmonary transplantation Each year 3-5 million people have severe cases and 250-500,000 die from complications of seasonal influenza world-wide. This year, the novel 2009 H1N1 (nH1N1) influenza, previously called swine flu, has reached pandemic status. Study examines treatment for olfactory loss after viral infection Treatment with a glucocorticoid medication, either alone or in combination with Ginkgo biloba, appears to significantly improve the sense of smell in individuals with previous olfactory loss due to upper respiratory infections. MedImmune to present data on RSV and influenza at 2009 AAP National Conference and Exhibition MedImmune announced today it will present four abstracts at the American Academy of Pediatrics (AAP) 2009 National Conference & Exhibition that add to the company's growing body of research on the burden of respiratory syncytial virus (RSV) on children, as well as pediatric infectious disease prevention. Pandemic flu can infect cells deep in the lungs, says new research Pandemic swine flu can infect cells deeper in the lungs than seasonal flu can, according to a new study published today in Nature Biotechnology. Diesel exhaust is linked to cancer development via new blood vessel growth Scientists here have demonstrated that the link between diesel fume exposure and cancer lies in how diesel exhaust induces the growth of new blood vessels that supply solid tumors. The researchers found that in both healthy and diseased animals, more new blood vessels sprouted in mice exposed to diesel exhaust than did in mice exposed to clean, filtered air. This suggests that previous illness isn't required to make humans susceptible to the damaging effects of the diesel exhaust. Blood transfusion study: Less is more A new study suggests that blood transfusions for hospitalized cardiac patients should be a last resort because they double the risk of infection and increase by four times the risk of death. Stress signals link pre-existing sickness with susceptibility to bacterial infection Mitochondrial diseases disrupt the power generating machinery within cells and increase a person's susceptibility to bacterial infection, particularly in the lungs or respiratory tract. Fruit and vegetable intake in pregnant women reduces risk of upper respiratory tract infection Boston University School of Medicine researchers (BUSM) have observed in a study of pregnant women that consumption of at least seven servings per day of fruits and vegetables moderately reduced the risk of developing an upper respiratory tract infection (URTI). Antibiotic prescribing should be standardized across Europe to help tackle resistance Antibiotic prescribing for respiratory illnesses should be standardised across Europe to help reduce inappropriate prescribing and resistance. More Respiratory Tract Current Events and Respiratory Tract News Articles |
|||||||||||||||||||||
|
|||||||||||||||||||||
|
|||||||||||||||||||||