ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2004
A diagnostic rule for the aetiology of lower respiratory tract infections as guidance for antimicrobial treatment.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 11 papers, 1 of them a synthesis that pooled it.
What it found
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.
- Guidelines for the management of adult lower respiratory tract infections--full version.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2011Guideline
- Disease Course of Lower Respiratory Tract Infection With a Bacterial Cause.Annals of family medicine · 2016Trial
- Symptoms Associated With Detection of Viral Versus Bacterial Pathogens in Outpatients With Lower Respiratory Infections.Influenza and other respiratory viruses · 2026Article
- Which Current and Novel Diagnostic Avenues for Bacterial Respiratory Diseases?Frontiers in microbiology · 2020Review
- Predicting the presence of bacterial pathogens in the airways of primary care patients with acute cough.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2017Article
- Pneumococcal lower respiratory tract infections in adults: an observational case-control study in primary care in Belgium.BMC family practice · 2015Observational
- Aetiology and prediction of pneumonia in lower respiratory tract infection in primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2007Article
- Antibiotic prescribing in primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2004Article
- Diagnosing coughs and colds.The British journal of general practice : the journal of the Royal College of General Practitioners · 2004Article
- Pathogens involved in lower respiratory tract infections in general practice.The British journal of general practice : the journal of the Royal College of General Practitioners · 2004Article
- Is dyspraxia a medical condition or a social disorder?The British journal of general practice : the journal of the Royal College of General Practitioners · 2004Article
Corrections and comments
- Commented on by
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- Erratum issued
Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe majority of patients with lower respiratory tract infections (LRTIs) are treated with antibiotics; some of them are unnecessary because of a viral cause. Information on prediction of the aetiology, especially in a general practice setting, is missing.
aimTo differentiate between viral and bacterial LRTI on simple clinical criteria, easily obtained at the bedside. DESIGN OF STUDY: Prospective observational study.
settingGeneral practices in the Leiden region of The Netherlands.
methodAdult patients with LRTI were included. Standard medical history and physical examination were performed. Sputum, blood and throat swabs were collected for diagnostic tests. According to microbiological findings, patients were classified as bacterial, viral, dual infection and unknown cause. In a logistic regression model independent predictors were determined. Scoring systems were developed. The accuracies of the diagnostic rules were tested by using receiver operating characteristic (ROC) curves.
resultsOne-hundred and forty-five patients were classified as having bacterial (n = 35), viral (n = 49), or dual infection (n = 8), or infection of unknown cause (n = 53), respectively. Independent predictors for bacterial infection were fever (odds ratio [OR] = 8.0; 95% confidence interval [CI] = 0.9 to 71.0), headache (OR = 4.3; 95% CI = 1.0 to 19.1) cervical painful lymph nodes (OR = 8.7; 95% CI = 1.1 to 68.0), diarrhoea (OR = 0.3; 95% CI = 0.1 to 1.0) and rhinitis (OR = 0.3; 95% CI = 0.1 to 0.9). As an additional independent predictor, an infiltrate on chest X-ray (OR = 5.0; 95% CI = 1.2 to 20.5) was found. The diagnostic rules developed from these variables classified the aetiology of LRTI with a ROC curve area of 0.79 (clinical score), 0.77 (simplified score) and 0.83 (extended score).
conclusionsA diagnostic rule was developed, based on information that is easy to obtain at the bedside, to predict a bacterial infection. This diagnostic rule may be a tool for general practitioners in their management of patients with LRTI.
Indexed as
Identifiers
14965402PMC1314773W1921530828What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.