ArticleBMJ open2017
Antibiotic use and bacterial complications following upper respiratory tract infections: a population-based study.
Article in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 1 of them a synthesis that pooled it.
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The trial behind it
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
29 citing papers in PubMed, 1 synthesis or guideline pooled it, 51 citations in OpenAlex.
- Antibiotic treatment to prevent pediatric acute otitis media infectious complications: A meta-analysis.PloS one · 2024Pooled it
- Echinacea reduces antibiotic usage in children through respiratory tract infection prevention: a randomized, blinded, controlled clinical trial.European journal of medical research · 2021Trial
- Effectiveness and safety of electronically delivered prescribing feedback and decision support on antibiotic use for respiratory illness in primary care: REDUCE cluster randomised trial.BMJ (Clinical research ed.) · 2019Trial
- Impact of the COVID-19 pandemic on antibiotic treatment for respiratory tract infections in Norwegian primary care.Scandinavian journal of primary health care · 2026Article
- Peritonsillitis in primary care: patient characteristics and care pathways - a population-based registry study.BMC primary care · 2026Article
- Impact of National Policies Promoting Appropriate Antibiotic Use on Outpatient Prescriptions and Hospitalizations for Bacterial Complications of Acute Respiratory Infections in Japan: An Interrupted Time-Series Analysis.Open forum infectious diseases · 2026Article
- Primary care pharyngotonsillitis complications following absent or deferred antibiotic treatment across the COVID 19 pandemic.Communications medicine · 2026Article
- Can the remuneration scheme of general practitioners affect their antibiotic prescription behaviour?Health economics review · 2026Article
- Antibiotic prescriptions to preschool children with respiratory tract infections in primary healthcare.JAC-antimicrobial resistance · 2026Article
- Relationships of Upper respiratory tract infections and holistic diets and lifestyles in Northeast China.BMC nutrition · 2025Article
- Association between antibiotic prescriptions for acute upper respiratory infections and pneumonia among older adults: a nationwide cohort study.BMC geriatrics · 2025Article
- Respiratory virus-induced bacterial dysregulation in pediatric airway tissue and the dual actions of Echinacea in reducing complications.Frontiers in pharmacology · 2025Article
- Echinacea Reduces Antibiotics by Preventing Respiratory Infections: A Meta-Analysis (ERA-PRIMA).Antibiotics (Basel, Switzerland) · 2024Review
- NSAID prescribing and adverse outcomes in common infections: a population-based cohort study.BMJ open · 2024Article
- Hospitalizations and severe complications following acute sinusitis in general practice: a registry-based cohort study.The Journal of antimicrobial chemotherapy · 2023Article
- A multi-institutional exploration of emergency medicine physicians' attitudes and behaviours on antibiotic use during the COVID-19 pandemic: a mixed-methods study.Antimicrobial resistance and infection control · 2023Article
- Antibiotic treatment of respiratory tract infections in adults in Norwegian general practice.JAC-antimicrobial resistance · 2023Article
- Associations between declining antibiotic use in primary care in Scotland and hospitalization with infection and patient satisfaction: longitudinal population study.The Journal of antimicrobial chemotherapy · 2022Article
- Paediatric Deep Neck Infection-The Risk of Needing Intensive Care.Children (Basel, Switzerland) · 2022Review
- Reduced dispensing of prescribed antibiotics during the Covid-19 pandemic has not increased severe complications from common infections.BMC public health · 2022Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo investigate if use of antibiotics was associated with bacterial complications following upper respiratory tract infections (URTIs).
designEcological time-trend analysis and a prospective cohort study.
settingPrimary, outpatient specialist and inpatient care in Stockholm County, Sweden. All analyses were based on administrative healthcare data on consultations, diagnoses and dispensed antibiotics from January 2006 to January 2016.
main outcome measures
resultsThe utilisation of respiratory tract antibiotics decreased by 22% from 2006 to 2015, but no increased trend for mastoiditis (p=0.0933), peritonsillar abscess (p=0.0544), invasive group A streptococcal disease (p=0.3991), orbital abscess (p=0.9637), extradural and subdural abscesses (p=0.4790) and pansinusitis (p=0.3971) was observed. For meningitis and acute ethmoidal sinusitis, a decrease in the numbers of infections from 2006 to 2015 was observed (p=0.0038 and p=0.0003, respectively), and for retropharyngeal and parapharyngeal abscesses, an increase was observed (p=0.0214). Bacterial complications following URTIs were uncommon in both antibiotic-exposed (less than 1.5 per 10 000 episodes) and non-exposed patients (less than 1.3 per 10 000 episodes) with the exception of peritonsillar abscess after tonsillitis (risk per 10 000 tonsillitis episodes: 32.4 and 41.1 in patients with no antibiotic treatment and patients treated with antibiotics, respectively).
conclusionsBacterial complications following URTIs are rare, and antibiotics may lack protective effect in preventing bacterial complications. Analyses of routinely collected administrative healthcare data can provide valuable information on the number of URTIs, antibiotic use and bacterial complications to patients, prescribers and policy-makers.
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