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http://hdl.handle.net/1942/27354
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DC Field | Value | Language |
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dc.contributor.author | BRUYNDONCKX, Robin | - |
dc.contributor.author | Stuart, B. | - |
dc.contributor.author | Little, P. | - |
dc.contributor.author | HENS, Niel | - |
dc.contributor.author | Ieven, Margareta | - |
dc.contributor.author | Butler, C. C. | - |
dc.contributor.author | Verheij, T. | - |
dc.contributor.author | Goossens, H. | - |
dc.contributor.author | Coenen, S. | - |
dc.date.accessioned | 2018-11-14T11:11:48Z | - |
dc.date.available | 2018-11-14T11:11:48Z | - |
dc.date.issued | 2018 | - |
dc.identifier.citation | CLINICAL MICROBIOLOGY AND INFECTION, 24(8), p. 871-876 | - |
dc.identifier.issn | 1198-743X | - |
dc.identifier.uri | http://hdl.handle.net/1942/27354 | - |
dc.description.abstract | Objective: We aimed to assess the effects of amoxicillin treatment in adult patients presenting to primary care with a lower respiratory tract infection (LRTI) who were infected with a potential bacterial, viral, or mixed bacterial/viral infection. Methods: This multicentre randomized controlled trial focused on adults with LRTI not suspected for pneumonia. Patients were randomized to receive either antibiotic (amoxicillin 1 g) or placebo three times daily for 7 consecutive days using computer-generated random numbers (follow-up 28 days). In this secondary analysis of the trial, symptom duration (primary outcome), symptom severity (scored 0-6), and illness deterioration (reconsultation with new or worsening symptoms, or hospital admission) were analysed in pre-specified subgroups using regression models. Subgroups of interest were patients with a (strictly) bacterial, (strictly) viral, or combined infection, and patients with elevated values of procalcitonin, C-reactive protein, or blood urea nitrogen. Results: 2058 patients (amoxicillin n = 1036; placebo n = 1022) were randomized. Treatment did not affect symptom duration (n = 1793). Patients from whom a bacterial pathogen only was isolated (n = 207) benefited from amoxicillin in that symptom severity (n = 804) was reduced by 0.26 points (95% CI -0.48 to -0.03). The odds of illness deterioration (n = 2024) was 0.24 (95% CI 0.11 to 0.53) times lower from treatment with amoxicillin when both a bacterial and a viral pathogen were isolated (combined infection; n = 198). Conclusions: Amoxicillin may reduce the risk of illness deterioration in patients with a combined bacterial and viral infection. We found no clinically meaningful benefit from amoxicillin treatment in other subgroups. (C) 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved. | - |
dc.description.sponsorship | The authors have no conflicts of interest to declare. GRACE was funded by the European Community's Sixth Framework Programme (grant agreement 518226). Work in the UK was also supported by the National Institute for Health Research, in Barcelona by 2009 SGR 911 Ciber de Enfermedades Respiratorias (Ciberes CB06/06/0028), and in Belgium by the Research Foundationd-Flanders (FWO; G.0274.08N). Financial support from the Methusalem financing program of the Flemish Government is also gratefully acknowledged. NH acknowledges support from the University of Antwerp scientific chair in evidence-based vaccinology, financed in 2009-2017 by a gift from Pfizer and GSK. This publication has been financially supported through the European Science Foundation, in the framework of the Research Networking Program TRACE (www.esf.org/trace). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. We thank all the clinicians and patients who consented to be part of GRACE, without whom this study would not have been possible. We are grateful to key members of the GRACE project group whose hard work has made this study possible, including Niels Adriaenssens, Jordi Almirall, Curt Brugman, Slawomir Chlabicz, An De Sutter, Mel Davies, Maciek Godycki-Cwirko, Patricia Fernandez, Iris Hering, Kerenza Hood, Greet Ieven Tom Schaberg, Antoni Torres, Anna Kowalczyk, Christine Lammens, Marieke Lemiengre, Frank Leus, Katherine Loens, Artur Mierzecki, Michael Moore, Magdalena Muras, Gilly O'Reilly, Nuria Sanchez Romano, Matteu Serra Prat, Jackie Swain, Robert Veen, and Tricia Worby. | - |
dc.language.iso | en | - |
dc.publisher | ELSEVIER SCI LTD | - |
dc.rights | 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved. | - |
dc.subject.other | Aetiology | - |
dc.subject.other | Amoxicillin | - |
dc.subject.other | Illness deterioration | - |
dc.subject.other | Lower respiratory tract infection | - |
dc.subject.other | Symptom duration | - |
dc.subject.other | Symptom severity | - |
dc.title | Amoxicillin for acute lower respiratory tract infection in primary care: subgroup analysis by bacterial and viral aetiology | - |
dc.type | Journal Contribution | - |
dc.identifier.epage | 876 | - |
dc.identifier.issue | 8 | - |
dc.identifier.spage | 871 | - |
dc.identifier.volume | 24 | - |
local.format.pages | 6 | - |
local.bibliographicCitation.jcat | A1 | - |
dc.description.notes | Hasselt Univ, Interuniv Inst Biostat & Stat Bioinformat IBIOSTA, Hasselt, Belgium. Univ Antwerp, Vaccine & Infect Dis Inst VAXINFECTIO, Lab Med Microbiol, Antwerp, Belgium. Univ Southampton, Aldermoor Hlth Ctr, Southampton, Hants, England. Univ Antwerp, Ctr Hlth Econ Res & Modelling Infect Dis CHERMID, Vaccine & Infect Dis Inst, Antwerp, Belgium. Cardiff Univ, Inst Primary Care & Publ Hlth, Cardiff, S Glam, Wales. Univ Med Ctr Utrecht, Julius Ctr Hlth Sci & Primary Care, Utrecht, Netherlands. Univ Antwerp, Dept Primary & Interdisciplinary Care ELIZA, Antwerp, Belgium. Univ Antwerp, Dept Epidemiol & Social Med ESOC, Antwerp, Belgium. | - |
local.publisher.place | THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND | - |
local.type.refereed | Refereed | - |
local.type.specified | Article | - |
dc.identifier.doi | 10.1016/j.cmi.2017.10.032 | - |
dc.identifier.isi | 000439403900015 | - |
dc.identifier.eissn | 1469-0691 | - |
local.uhasselt.international | yes | - |
item.fulltext | With Fulltext | - |
item.fullcitation | BRUYNDONCKX, Robin; Stuart, B.; Little, P.; HENS, Niel; Ieven, Margareta; Butler, C. C.; Verheij, T.; Goossens, H. & Coenen, S. (2018) Amoxicillin for acute lower respiratory tract infection in primary care: subgroup analysis by bacterial and viral aetiology. In: CLINICAL MICROBIOLOGY AND INFECTION, 24(8), p. 871-876. | - |
item.accessRights | Open Access | - |
item.contributor | BRUYNDONCKX, Robin | - |
item.contributor | Stuart, B. | - |
item.contributor | Little, P. | - |
item.contributor | HENS, Niel | - |
item.contributor | Ieven, Margareta | - |
item.contributor | Butler, C. C. | - |
item.contributor | Verheij, T. | - |
item.contributor | Goossens, H. | - |
item.contributor | Coenen, S. | - |
crisitem.journal.issn | 1198-743X | - |
crisitem.journal.eissn | 1469-0691 | - |
Appears in Collections: | Research publications |
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26617.pdf | Peer-reviewed author version | 222.79 kB | Adobe PDF | View/Open |
Amoxicillin for acute lower respiratory tract infection in primary care_ subgroup analysis by bacterial and viral aetiology.pdf Restricted Access | Published version | 598.62 kB | Adobe PDF | View/Open Request a copy |
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