Clinical presentation and disease course in patients with flu-like illness: does microbiological aetiology matter?
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Clinical presentation and disease course in patients with flu-like illness : does microbiological aetiology matter? / Verheij, Theo; Cianci, Daniela; van der Velden, Alike; Butler, Christopher C; Bongard, Emily; Coenen, Samuel; Colliers, Annelies; Francis, Nick; Little, Paul; Godycki-Cwirko, Maciek; Llor, Carl; Chlabicz, Slawomir; Lionis, Christos; Sundvall, Pär-Daniel; Bjerrum, Lars; De Sutter, An; Aabenhus, Rune; Jonassen Harbin, Nicolay; Lindbaek, Morten; Glinz, Dominik; Bucher, Heiner; Kovacs, Bernadett; Seifert, Bohumil; Touboul Lundgren, Pia; de Paor, Muireann; Radzeviciene JUrgute, Ruta; Matheeussen, Veerle; Goossens, Herman; Ieven, Margareta.
In: The British journal of general practice : the journal of the Royal College of General Practitioners, Vol. 72, 716, 2022, p. e217-e224.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Clinical presentation and disease course in patients with flu-like illness
T2 - does microbiological aetiology matter?
AU - Verheij, Theo
AU - Cianci, Daniela
AU - van der Velden, Alike
AU - Butler, Christopher C
AU - Bongard, Emily
AU - Coenen, Samuel
AU - Colliers, Annelies
AU - Francis, Nick
AU - Little, Paul
AU - Godycki-Cwirko, Maciek
AU - Llor, Carl
AU - Chlabicz, Slawomir
AU - Lionis, Christos
AU - Sundvall, Pär-Daniel
AU - Bjerrum, Lars
AU - De Sutter, An
AU - Aabenhus, Rune
AU - Jonassen Harbin, Nicolay
AU - Lindbaek, Morten
AU - Glinz, Dominik
AU - Bucher, Heiner
AU - Kovacs, Bernadett
AU - Seifert, Bohumil
AU - Touboul Lundgren, Pia
AU - de Paor, Muireann
AU - Radzeviciene JUrgute, Ruta
AU - Matheeussen, Veerle
AU - Goossens, Herman
AU - Ieven, Margareta
N1 - Copyright © 2021, The Authors.
PY - 2022
Y1 - 2022
N2 - BACKGROUND: There is little evidence about the relation between aetiology, illness severity and clinical course of respiratory tract infections (RTI) in primary care. Understanding these associations would aid to develop effective management strategies for these infections.AIM: To investigate whether the clinical presentation and illness course differ between RTI in whom a viral pathogen was detected and those in whom a potential bacterial pathogen was found.DESIGN AND SETTING: Post hoc analysis of data from a pragmatic randomised trial on the effects of oseltamivir in patients with influenza-like illness (ILI) in primary care (n=3266) in 15 European countries.METHODS: Patient characteristics, signs and symptoms were registered at baseline. Naso-pharyngeal (adults) or nasal and pharyngeal (children) swabs were taken for PCR analysis. Patients were followed up until 28 days after inclusion. Regression models and Kaplan-Meier curves were used to analyse the relation between aetiology, clinical presentation at baseline and course of disease including complications.RESULTS: Except for a less prominent congested nose (OR 0.55, CI 0.35 - 0.86) and acute cough (OR 0.52, CI 0.27 - 0.65) in ILI patients in whom a possible bacterial pathogen was isolated, there were no clear clinical differences in presentations between those with a possible bacterial aetiology than in those with a viral one. Also the course of disease and complications were not related to aetiology.CONCLUSION: Given the currently available microbiological tests and antimicrobial treatments, and outside pandemics like COVID-19, microbiological testing in primary care patients with ILI seems to have limited value.
AB - BACKGROUND: There is little evidence about the relation between aetiology, illness severity and clinical course of respiratory tract infections (RTI) in primary care. Understanding these associations would aid to develop effective management strategies for these infections.AIM: To investigate whether the clinical presentation and illness course differ between RTI in whom a viral pathogen was detected and those in whom a potential bacterial pathogen was found.DESIGN AND SETTING: Post hoc analysis of data from a pragmatic randomised trial on the effects of oseltamivir in patients with influenza-like illness (ILI) in primary care (n=3266) in 15 European countries.METHODS: Patient characteristics, signs and symptoms were registered at baseline. Naso-pharyngeal (adults) or nasal and pharyngeal (children) swabs were taken for PCR analysis. Patients were followed up until 28 days after inclusion. Regression models and Kaplan-Meier curves were used to analyse the relation between aetiology, clinical presentation at baseline and course of disease including complications.RESULTS: Except for a less prominent congested nose (OR 0.55, CI 0.35 - 0.86) and acute cough (OR 0.52, CI 0.27 - 0.65) in ILI patients in whom a possible bacterial pathogen was isolated, there were no clear clinical differences in presentations between those with a possible bacterial aetiology than in those with a viral one. Also the course of disease and complications were not related to aetiology.CONCLUSION: Given the currently available microbiological tests and antimicrobial treatments, and outside pandemics like COVID-19, microbiological testing in primary care patients with ILI seems to have limited value.
U2 - 10.3399/BJGP.2021.0344
DO - 10.3399/BJGP.2021.0344
M3 - Journal article
C2 - 34990385
VL - 72
SP - e217-e224
JO - British Journal of General Practice
JF - British Journal of General Practice
SN - 0960-1643
M1 - 716
ER -
ID: 290232681