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Antibiotic Treatment for Lower Respiratory Tract Infections in Primary Care : A Register-Based Study Examining the Role of Radiographic Imaging

Carlsson, Sara ; Hedin, Katarina LU ; Cronberg, Olof LU orcid and Moberg, Anna (2023) In Antibiotics 12(7).
Abstract

When imaging (i.e., chest-x-ray or computed tomography) is used to differentiate between acute bronchitis and pneumonia, many patients are being prescribed antibiotics despite the absence of radiographic pneumonia signs. This study of lower respiratory tract infections (LRTIs) with negative chest imaging compares cases where antibiotics were prescribed and not prescribed to find characteristics that could explain the prescription. Data were extracted from the regional electronic medical record system in Kronoberg County, Sweden, for patients aged 18-79 years diagnosed with acute bronchitis or pneumonia and who had any chest radiologic imaging between 2007-2014. Of 696 cases without evidence of pneumonia on imaging, 55% were prescribed... (More)

When imaging (i.e., chest-x-ray or computed tomography) is used to differentiate between acute bronchitis and pneumonia, many patients are being prescribed antibiotics despite the absence of radiographic pneumonia signs. This study of lower respiratory tract infections (LRTIs) with negative chest imaging compares cases where antibiotics were prescribed and not prescribed to find characteristics that could explain the prescription. Data were extracted from the regional electronic medical record system in Kronoberg County, Sweden, for patients aged 18-79 years diagnosed with acute bronchitis or pneumonia and who had any chest radiologic imaging between 2007-2014. Of 696 cases without evidence of pneumonia on imaging, 55% were prescribed antibiotics. Age, sex, and co-morbidity did not differ between those with or without antibiotics. The median level of C-reactive protein was low in both groups but differed significantly (21 vs. 10 mg/L;
p < 0.001). Resident physicians prescribed antibiotics more frequently than interns or specialists (
p < 0.001). It is unclear what features prompted the antibiotic prescribing in those with negative imaging indicating overuse of antibiotics for LRTIs.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Antibiotics
volume
12
issue
7
article number
1165
publisher
MDPI AG
external identifiers
  • scopus:85184508494
  • pmid:37508261
ISSN
2079-6382
DOI
10.3390/antibiotics12071165
language
English
LU publication?
yes
id
c53e08f2-1e7a-4d51-b4f3-e33896b2d144
date added to LUP
2023-08-17 11:56:55
date last changed
2024-04-23 15:59:08
@article{c53e08f2-1e7a-4d51-b4f3-e33896b2d144,
  abstract     = {{<p>When imaging (i.e., chest-x-ray or computed tomography) is used to differentiate between acute bronchitis and pneumonia, many patients are being prescribed antibiotics despite the absence of radiographic pneumonia signs. This study of lower respiratory tract infections (LRTIs) with negative chest imaging compares cases where antibiotics were prescribed and not prescribed to find characteristics that could explain the prescription. Data were extracted from the regional electronic medical record system in Kronoberg County, Sweden, for patients aged 18-79 years diagnosed with acute bronchitis or pneumonia and who had any chest radiologic imaging between 2007-2014. Of 696 cases without evidence of pneumonia on imaging, 55% were prescribed antibiotics. Age, sex, and co-morbidity did not differ between those with or without antibiotics. The median level of C-reactive protein was low in both groups but differed significantly (21 vs. 10 mg/L;<br>
 p &lt; 0.001). Resident physicians prescribed antibiotics more frequently than interns or specialists ( <br>
 p &lt; 0.001). It is unclear what features prompted the antibiotic prescribing in those with negative imaging indicating overuse of antibiotics for LRTIs.<br>
 </p>}},
  author       = {{Carlsson, Sara and Hedin, Katarina and Cronberg, Olof and Moberg, Anna}},
  issn         = {{2079-6382}},
  language     = {{eng}},
  number       = {{7}},
  publisher    = {{MDPI AG}},
  series       = {{Antibiotics}},
  title        = {{Antibiotic Treatment for Lower Respiratory Tract Infections in Primary Care : A Register-Based Study Examining the Role of Radiographic Imaging}},
  url          = {{http://dx.doi.org/10.3390/antibiotics12071165}},
  doi          = {{10.3390/antibiotics12071165}},
  volume       = {{12}},
  year         = {{2023}},
}