Abstract:
PURPOSE:Bacterial pathogens are assumed to cause an illness course different from that of nonbacterial causes of acute cough, but evidence is lacking. We evaluated the disease course of lower respiratory tract infection (LRTI) with a bacterial cause in adults with acute cough. METHODS:We conducted a secondary analysis of a multicenter European trial in which 2,061 adults with acute cough (28 days' duration or less) were recruited from primary care and randomized to amoxicillin or placebo. For this analysis only patients in the placebo group (n = 1,021) were included, reflecting the natural course of disease. Standardized microbiological and serological analyses were performed at baseline to define a bacterial cause. All patients recorded symptoms in a diary for 4 weeks. The disease course between those with and without a bacterial cause was compared by symptom severity in days 2 to 4, duration of symptoms rated moderately bad or worse, and a return consultation. RESULTS:Of 1,021 eligible patients, 187 were excluded for missing diary records, leaving 834 patients, of whom 162 had bacterial LRTI. Patients with bacterial LRTI had worse symptoms at day 2 to 4 after the first office visit (P = .014) and returned more often for a second consultation, 27% vs 17%, than those without bacterial LRTI (P = .004). Resolution of symptoms rated moderately bad or worse did not differ (P = .375). CONCLUSIONS:Patients with acute bacterial LRTI have a slightly worse course of disease when compared with those without an identified bacterial cause, but the relevance of this difference is not meaningful.
journal_name
Ann Fam Medjournal_title
Annals of family medicineauthors
Teepe J,Broekhuizen BD,Loens K,Lammens C,Ieven M,Goossens H,Little P,Butler CC,Coenen S,Godycki-Cwirko M,Verheij T,GRACE Consortium.doi
10.1370/afm.1974subject
Has Abstractpub_date
2016-11-01 00:00:00pages
534-539issue
6eissn
1544-1709issn
1544-1717pii
14/6/534journal_volume
14pub_type
杂志文章,多中心研究,随机对照试验abstract::William Osler is quoted as saying, "Nothing will sustain you more potently than the power to recognize in your humdrum routine, as perhaps it may be thought, the true poetry of life-the poetry of the commonplace, of the plain, toil-worn woman, with their loves and their joys, their sorrows and their griefs."(1) A fami...
journal_title:Annals of family medicine
pub_type: 杂志文章
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abstract::When I began experiencing chest pain that was different from my usual heartburn symptoms, I denied I could possibly be having a heart attack, but chewed 4 baby aspirin just in case. Despite years of community education about the need to call 911 and seek immediate emergency care when experiencing signs and symptoms of...
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journal_title:Annals of family medicine
pub_type: 杂志文章,多中心研究,随机对照试验
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