Increasing antimicrobial resistance requires more careful use of antibiotics in order to preserve their future effectiveness. Increasing emphasis is now being given to reducing unnecessary use of antibiotics especially for common respiratory tract infections in the community. In order to achieve this we need better understanding of the risks of infectious complications including pneumonia, if antibiotics are, or are not, prescribed. Some patients presenting in general practice with complaints of common respiratory tract infections, including colds, sore throat, otitis media, sinusitis and bronchitis, might benefit from antibiotic treatment to prevent them from developing pulmonary infectious complications, including pneumonia. A better understanding of risk factors for developing pneumonia following common respiratory tract infections will contribute to informing prescribing practice and the containment of antimicrobial resistance. In this study, we will investigate risk factors for pneumonia complicating a presentation of common RTI. We aim to identify key risk factors for pneumonia cases following common RTI consultations using linked general practice (CPRD) and hospital (HES) records. This information will help to support policies for more informative antibiotic prescribing strategies in general practice. The results can also be used by policy makers and the public in general to understand when antibiotics are not required, and when they are.
The increasing challenge of antimicrobial resistance requires more judicious use of antibiotics. Primary care prescribers are encouraged to treat self-limiting respiratory tract infections (including colds, sore throat, otitis media, sinusitis and bronchitis) without antibiotics in order to curb their unnecessary use. This approach could be hazardous for some subgroups of patients that may be at higher risk of infectious complications, including pneumonia. Identification of risk factors contributing secondary pneumonia following self-limiting respiratory tract infection consultations will help to assist clinical decision making and disease management in primary care. In a nested case-control study, cases will be adult patients presenting with RTI in primary care who develop secondary pneumonia within 30 days, while controls will be patients with RTI who did not have pneumonia. A systematic review will be conducted to contribute to identifying candidate risk factors. Conditional logistic regression will be employed to adjust for confounding. We also aim to develop a clinical prediction model for pneumonia following self-limiting respiratory tract infection using a cohort of patients presenting with RTI. Analyses will follow good practice recommendations for prediction model development including assessment of model performance and validity. The study will provide improved understanding of risk factors for pneumonia following self-limiting RTI in adults
Martin Gulliford - Chief Investigator - King's College London (KCL)
Xiaohui Sun - Corresponding Applicant - King's College London (KCL)
HES Admitted Patient Care;Patient Level Index of Multiple Deprivation;Practice Level Index of Multiple Deprivation