Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/35873
Title: The Effect of Amoxicillin in Adult Patients Presenting to Primary Care with Acute Cough Predicted to Have Pneumonia or a Combined Viral-Bacterial Infection
Authors: BRUYNDONCKX, Robin 
Stuart, B
Little, P
HENS, Niel 
Ieven , M
Butler, C
Verheij, T
Goossens, H
Coenen , S
Issue Date: 2021
Publisher: MDPI
Source: Antibiotics (Basel), 10 (7) (Art N° 817)
Abstract: While most cases of acute cough are self-limiting, antibiotics are prescribed to over 50%. This proportion is inappropriately high given that benefit from treatment with amoxicillin could only be demonstrated in adults with pneumonia (based on chest radiograph) or combined viral-bacterial infection (based on modern microbiological methodology). As routine use of chest radiographs and microbiological testing is costly, clinical prediction rules could be used to identify these patient subsets. In this secondary analysis of data from a multicentre randomised controlled trial in adults presenting to primary care with acute cough, we used prediction rules for pneumonia or combined infection and assessed the effect of amoxicillin in patients predicted to have pneumonia or combined infection on symptom duration, symptom severity and illness deterioration. In total, 2056 patients that fulfilled all inclusion criteria were randomised, 1035 to amoxicillin, 1021 to placebo. Neither patients with a predicted pneumonia nor patients with a predicted combined infection were significantly more likely to benefit from amoxicillin. While the studied clinical prediction rules may help primary care clinicians to reduce antibiotic prescribing for low-risk patients, they did not identify adult acute cough patients that would benefit from amoxicillin treatment.
Keywords: adults;amoxicillin;benefit of treatment;clinical prediction rule;lower respiratory tract infection;pneumonia;primary care;viral-bacterial infection
Document URI: http://hdl.handle.net/1942/35873
ISSN: 2079-6382
e-ISSN: 2079-6382
DOI: 10.3390/antibiotics10070817
ISI #: 000676004900001
Rights: 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Category: A1
Type: Journal Contribution
Validations: ecoom 2022
Appears in Collections:Research publications

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