Acute respiratory symptoms in adults in general practice

Hong, Cassandra; Lin, Raymond Tzer‐Pin; Tan, E. S. L.; Chong, Phui-Nah; Tan, Yvette S. L.; Lew, Yii-Jen; Loo, Liat Hui

doi:10.1093/fampra/cmh319

Cited by 28 publications

(24 citation statements)

References 20 publications

(18 reference statements)

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“…Acute respiratory infections (ARI) are among the most common reasons for seeking medical attention in the United States (Hong et al, 2004; Johnstone et al, 2008). Rhinovirus (HRV), influenza, and respiratory syncytial virus (RSV) are recognized as leading etiologies of ARI in adults (Peltola et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

Gene Expression Signatures Diagnose Influenza and Other Symptomatic Respiratory Viral Infections in Humans

Zaas

Chen

Varkey

et al. 2009

Cell Host & Microbe

377

487

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Summary Acute respiratory infections (ARI) are a common reason for seeking medical attention and the threat of pandemic influenza will likely add to these numbers. Using human viral challenge studies with live rhinovirus, respiratory syncytial virus, and influenza A, we developed peripheral blood gene expression signatures that distinguish individuals with symptomatic ARI from uninfected individuals with > 95% accuracy. We validated this “acute respiratory viral” signature - encompassing genes with a known role in host defense against viral infections - across each viral challenge. We also validated the signature in an independently acquired dataset for influenza A and classified infected individuals from healthy controls with 100% accuracy. In the same dataset, we could also distinguish viral from bacterial ARIs (93% accuracy). These results demonstrate that ARIs induce changes in human peripheral blood gene expression that can be used to diagnose a viral etiology of respiratory infection and triage symptomatic individuals.

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Section: Introductionmentioning

confidence: 99%

Gene Expression Signatures Diagnose Influenza and Other Symptomatic Respiratory Viral Infections in Humans

Zaas

Chen

Varkey

et al. 2009

Cell Host & Microbe

377

487

View full text Add to dashboard Cite

show abstract

“…While there is no local data on antibiotic use for URTIs in Singapore, it has been noted that antibiotics are commonly prescribed for URTIs [13]. However, current evidence-based guidelines do not support antibiotic use in the majority of URTI cases [14, 15], as URTIs are frequently of viral etiology [16–18]. are often self-limiting [19, 20], and seldom lead to serious complications [21].…”

Section: Introductionmentioning

confidence: 99%

Knowledge, attitudes and practices towards antibiotic use in upper respiratory tract infections among patients seeking primary health care in Singapore

et al. 2016

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BackgroundPatients’ expectations can influence antibiotic prescription by primary healthcare physicians. We assessed knowledge, attitude and practices towards antibiotic use for upper respiratory tract infections (URTIs), and whether knowledge is associated with increased expectations for antibiotics among patients visiting primary healthcare services in Singapore.MethodsData was collected through a cross-sectional interviewer-assisted survey of patients aged ≥21 years waiting to see primary healthcare practitioners for one or more symptoms suggestive of URTI (cough, sore throat, runny nose or blocked nose) for 7 days or less, covering the demographics, presenting symptoms, knowledge, attitudes, beliefs and practices of URTI and associated antibiotic use. Univariate and multivariate logistic regression was used to assess independent factors associated with patients’ expectations for antibiotics.ResultsNine hundred fourteen out of 987 eligible patients consulting 35 doctors were recruited from 24 private sector primary care clinics in Singapore. A third (307/907) expected antibiotics, of which a substantial proportion would ask the doctor for antibiotics (121/304, 40 %) and/or see another doctor (31/304, 10 %) if antibiotics were not prescribed. The majority agreed “antibiotics are effective against viruses” (715/914, 78 %) and that “antibiotics cure URTI faster” (594/912, 65 %). Inappropriate antibiotic practices include “keeping antibiotics stock at home” (125/913, 12 %), “taking leftover antibiotics” (114/913, 14 %) and giving antibiotics to family members (62/913, 7 %). On multivariate regression, the following factors were independently associated with wanting antibiotics (odds ratio; 95 % confidence interval): Malay ethnicity (1.67; 1.00–2.79), living in private housing (1.69; 1.13–2.51), presence of sore throat (1.50; 1.07–2.10) or fever (1.46; 1.01–2.12), perception that illness is serious (1.70; 1.27–2.27), belief that antibiotics cure URTI faster (5.35; 3.76–7.62) and not knowing URTI resolves on its own (2.18; 1.08–2.06), while post-secondary education (0.67; 0.48–0.94) was inversely associated. Those with lower educational levels were significantly more likely to have multiple misconceptions about antibiotics.ConclusionMajority of patients seeking primary health care in Singapore are misinformed about the role of antibiotics in URTI. Agreeing with the statement that antibiotics cure URTI faster was most strongly associated with wanting antibiotics. Those with higher educational levels were less likely to want antibiotics, while those with lower educational levels more likely to have incorrect knowledge.Electronic supplementary materialThe online version of this article (doi:10.1186/s12875-016-0547-3) contains supplementary material, which is available to authorized users.

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“…18 It encompasses sinus, pharyngeal and lower airway symptoms, where none of the symptoms are dominant and the exact site of infection cannot be clearly established. 19 URTI is primarily viral in etiology [20,21,22] and in most cases, will resolve spontaneously within one to two weeks. 19 URTIs do not require antimicrobial agents unless they are complicated by acute otitis media (AOM) with effusion, tonsillitis, sinusitis and lower respiratory tract infection.…”

Section: Discussionmentioning

confidence: 99%

“…The main bacterial pathogen in URTI is the group A β-hemolytic streptococcus, which was found to be present in only 2.4 to 17% of adults who presented with URTI symptoms. [20,21,22] The increasing resistance of these antimicrobials in upper respiratory tract pathogens is of great concern. Selection of an anti-infective agent regimen for the treatment of upper respiratory tract pathogens should be based on the drug spectrum of activity as well as the regimen's bacteriologic and clinical efficacy, potential adverse effects, ease of administration, patient compliance and cost.…”

Section: Discussionmentioning

confidence: 99%

An Analysis of the Pharmacological Management of Respiratory Tract Infections in-Patients at a Tertiary Care Teaching Hospital

Pal¹

2018

jmscr

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Acute respiratory symptoms in adults in general practice

Abstract: In about half of patients who presented at NHGPs, no pathogens could be identified even after PCR. A non-infective aetiology could be considered in these patients.

Cited by 28 publications

References 20 publications

Gene Expression Signatures Diagnose Influenza and Other Symptomatic Respiratory Viral Infections in Humans

Gene Expression Signatures Diagnose Influenza and Other Symptomatic Respiratory Viral Infections in Humans

Knowledge, attitudes and practices towards antibiotic use in upper respiratory tract infections among patients seeking primary health care in Singapore

An Analysis of the Pharmacological Management of Respiratory Tract Infections in-Patients at a Tertiary Care Teaching Hospital

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