Evidence map›Paper›PMID 31844897›Full record

ArticleFamily practice2020

Relationship between microbiology of throat swab and clinical course among primary care patients with acute cough: a prospective cohort study.

José M Ordóñez-Mena, Thomas R Fanshawe, Chris C Butler, David Mant, Denise Longhurst, Peter Muir, Barry Vipond, Paul Little, Michael Moore, Beth Stuart and 9 more

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Family practice, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
0.8field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 12 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors at 7 institutions in 3 countries.

José M Ordóñez-MenaNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Thomas R FanshaweNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Chris C ButlerNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
David MantNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Denise LonghurstSouth West Regional Laboratory, National Infection Service, Public Health England, Bristol, UK.
Peter MuirSouth West Regional Laboratory, National Infection Service, Public Health England, Bristol, UK.
Barry VipondSouth West Regional Laboratory, National Infection Service, Public Health England, Bristol, UK.
Paul LittleUniversity of Southampton, Primary Care and Population Sciences, Aldermoor Health Centre, Southampton, UK.
Michael MooreUniversity of Southampton, Primary Care and Population Sciences, Aldermoor Health Centre, Southampton, UK.
Beth StuartUniversity of Southampton, Primary Care and Population Sciences, Aldermoor Health Centre, Southampton, UK.
Alastair D HayCentre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Hannah V ThorntonCentre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Matthew J ThompsonDepartment of Family Medicine, University of Washington, Seattle, WA, USA.
Sue SmithNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Ann Van den BruelDepartment of Public Health and Primary Care, KU Leuven, Belgium.
Victoria HardyDepartment of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
Laikin CheahNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Derrick CrookNuffield Department of Clinical Laboratory Sciences, University of Oxford, Oxford, UK.
Kyle KnoxNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
University of Oxford · GBPublic Health England · GBUniversity of Southampton · GBUniversity of Bristol · GBKU Leuven · BEUniversity of Cambridge · GBUniversity of Washington · US

Funding

Department of Health
6 · The paper itself

Abstract

backgroundAcute lower respiratory tract infections (ALRTIs) account for most antibiotics prescribed in primary care despite lack of efficacy, partly due to clinician uncertainty about aetiology and patient concerns about illness course. Nucleic acid amplification tests could assist antibiotic targeting.

methodsIn this prospective cohort study, 645 patients presenting to primary care with acute cough and suspected ALRTI, provided throat swabs at baseline. These were tested for respiratory pathogens by real-time polymerase chain reaction and classified as having a respiratory virus, bacteria, both or neither. Three hundred fifty-four participants scored the symptoms severity daily for 1 week in a diary (0 = absent to 4 = severe problem).

resultsOrganisms were identified in 346/645 (53.6%) participants. There were differences in the prevalence of seven symptoms between the organism groups at baseline. Those with a virus alone, and those with both virus and bacteria, had higher average severity scores of all symptoms combined during the week of follow-up than those in whom no organisms were detected [adjusted mean differences 0.204 (95% confidence interval 0.010 to 0.398) and 0.348 (0.098 to 0.598), respectively]. There were no differences in the duration of symptoms rated as moderate or severe between organism groups.

conclusionsDifferences in presenting symptoms and symptoms severity can be identified between patients with viruses and bacteria identified on throat swabs. The magnitude of these differences is unlikely to influence management. Most patients had mild symptoms at 7 days regardless of aetiology, which could inform patients about likely symptom duration.

Indexed as

AdultAgedAnti-Bacterial AgentsBacteriaBacterial InfectionsCoughEnglandFemaleHumansLinear ModelsMaleMiddle AgedPharynxPrimary Health CareProspective StudiesRespiratory Tract InfectionsAnti-Bacterial Agentsbacterialdiagnosisinfectionmicrobiologysymptomsviral

Identifiers

PMID31844897
PMCPMC7108489
OpenAlexW2992635384

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.