Observational studyThe journal of allergy and clinical immunology. In practice
Respiratory Infections and Antibiotic Usage in Common Variable Immunodeficiency.
Observational study in The journal of allergy and clinical immunology. In practice. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
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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
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 53 citations in OpenAlex.
- Lessons Learned From the Clinical Presentation of Common Variable Immunodeficiency Disorders: A Systematic Review and Meta-Analysis.Frontiers in immunology · 2021Pooled it
- Current infectious disease management challenges in inborn errors of immunity.Annals of clinical microbiology and antimicrobials · 2025Review
- Article
- Oropharyngeal microbial ecosystem perturbations influence the risk for acute respiratory infections in common variable immunodeficiency.Frontiers in immunology · 2024Article
- Contribution of immunoglobulin products in influencing seasonal influenza infection and severity in antibody immune deficiency patients receiving immunoglobulin replacement therapy.Frontiers in immunology · 2024Review
- Antibiotic resistance, bacterial transmission and improved prediction of bacterial infection in patients with antibody deficiency.JAC-antimicrobial resistance · 2023Article
- Evaluating Drug Prescription Patterns in Undiagnosed Common Variable Immunodeficiency Patients.Journal of clinical immunology · 2023Article
- Is there a role for microbiome-based approach in common variable immunodeficiency?Clinical and experimental medicine · 2023Review
- Current Issues in the Management of IgG Subclass Deficiencies in Adults With Chronic Respiratory Diseases.Allergy, asthma & immunology research · 2023Review
- ERS International Congress 2022: highlights from the Paediatrics Assembly.ERJ open research · 2023Review
- ERS International Congress 2022: highlights from the Thoracic Surgery and Lung Transplantation Assembly.ERJ open research · 2023Review
- Turning walking pneumonia into recurrent abscesses: a curious case of CVID and review of the literature.Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology · 2022Article
- Predictive Factors for and Complications of Bronchiectasis in Common Variable Immunodeficiency Disorders.Journal of clinical immunology · 2022Observational
- Case Report: Whole-Genome Sequencing of Serially CollectedFrontiers in cellular and infection microbiology · 2022Article
- Function matters: Coronavirus cross-binding antibodies do not cross-neutralize.Frontiers in medicine · 2022Article
- Generation of recombinant hyperimmune globulins from diverse B-cell repertoires.Nature biotechnology · 2021Article
- Gut Microbiome and Common Variable Immunodeficiency: Few Certainties and Many Outstanding Questions.Frontiers in immunology · 2021Review
- Trained Immunity Based-Vaccines as a Prophylactic Strategy in Common Variable Immunodeficiency. A Proof of Concept Study.Biomedicines · 2020Article
- Histology of Interstitial Lung Disease in Common Variable Immune Deficiency.Frontiers in immunology · 2020Review
- Evaluation of pulmonary findings in patients with humoral immunodeficiency.Turk pediatri arsivi · 2020Article
Corrections and comments
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Authors and funding
10 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatients with common variable immunodeficiency (CVID) suffer frequent respiratory tract infections despite immunoglobulin replacement and are prescribed significant quantities of antibiotics. The clinical and microbiological nature of these exacerbations, the symptomatic triggers to take antibiotics, and the response to treatment have not been previously investigated.
objectivesTo describe the nature, frequency, treatment, and clinical course of respiratory tract exacerbations in patients with CVID and to describe pathogens isolated during respiratory tract exacerbations.
methodsWe performed a prospective diary card exercise in 69 patients with CVID recruited from a primary immunodeficiency clinic in the United Kingdom, generating 6210 days of symptom data. We collected microbiology (sputum microscopy and culture, atypical bacterial PCR, and mycobacterial culture) and virology (nasopharyngeal swab multiplex PCR) samples from symptomatic patients with CVID.
resultsThere were 170 symptomatic exacerbations and 76 exacerbations treated by antibiotics. The strongest symptomatic predictors for commencing antibiotics were cough, shortness of breath, and purulent sputum. There was a median delay of 5 days from the onset of symptoms to commencing antibiotics. Episodes characterized by purulent sputum responded more quickly to antibiotics, whereas sore throat and upper respiratory tract symptoms responded less quickly. A pathogenic virus was isolated in 56% of respiratory exacerbations and a potentially pathogenic bacteria in 33%.
conclusionsPatients with CVID delay and avoid treatment of symptomatic respiratory exacerbations, which could result in structural lung damage. However, viruses are commonly represented and illnesses dominated by upper respiratory tract symptoms respond poorly to antibiotics, suggesting that antibiotic usage could be better targeted.
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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.