Reducing uncertainty in managing respiratory tract infections in primary care

British Journal of General Practice

Nick A Francis¹  Chris C Butler¹  Naomi Stanton¹ 

[1] Department of Primary Care and Public Health, Cardiff University, Cardiff

关键词: anti-bacterial agents;    cough;    primary health care;    respiratory tract infections;   

DOI  :  10.3399/bjgp10X544104

学科分类：卫生学

来源: Royal College of General Practitioners

【 摘 要 】

Respiratory tract infections (RTIs) remain the commonest reason for acute consultations in primary care in resource-rich countries. Their spectrum and severity has changed from the time that antibiotics were discovered, largely from improvements in the socioeconomic determinants of health as well as vaccination. The benefits from antibiotic treatment for common RTIs have been shown to be largely overstated. Nevertheless, serious infections do occur. Currently, no clinical features or diagnostic test, alone or in combination, adequately determine diagnosis, aetiology, prognosis, or response to treatment. This narrative review focuses on emerging evidence aimed at helping clinicians reduce and manage uncertainty in treating RTIs. Consultation rate and prescribing rate trends are described, evidence of increasing rates of complications are discussed, and studies and the association with antibiotic prescribing are examined. Methods of improving diagnosis and identifying those patients who are at increased risk of complications from RTIs, using clinical scoring systems, biomarkers, and point of care tests are also discussed. The evidence for alternative management options for RTIs are summarised and the methods for changing public and clinicians' beliefs about antibiotics, including ways in which we can improve clinician–patient communication skills for management of RTIs, are described.

【 授权许可】

Unknown