Materiały źródłowe

• #1 Respiratory Tract Infections – Antibiotic Prescribing – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK53632/

  Respiratory tract infection (RTI) is defined as any infectious disease of the upper or lower respiratory tract. Upper respiratory tract infections (URTIs) include the common cold, laryngitis, pharyngitis/tonsillitis, acute rhinitis, acute rhinosinusitis and acute otitis media. Lower respiratory tract infections (LRTIs) include acute bronchitis, bronchiolitis, pneumonia and tracheitis. Antibiotics are commonly prescribed for RTIs in adults and children in primary care. General practice consultation rates in England and Wales show that a quarter of the population will visit their GP because of an RTI each year (Ashworth et al. 2005). RTIs are the reason for 60% of all antibiotic prescribing in general practice, and this constitutes a significant cost to the NHS. Annual prescribing costs for acute cough alone exceed 15 million (Lindbaek 2006).

• #2 Predisposing factors to acquisition of acute respiratory tract infections in the community: a systematic review and meta-analysis | BMC Infectious Diseases | Full Text

  https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-021-06954-3

  Preventing respiratory tract infections (RTIs) could have profound effects on quality of life, primary care workload, antibiotic prescribing and stewardship. […] We identified several modifiable risk factors associated with increased likelihood of acquiring RTIs in the community, including low BMI, contact with children and pets. […] Respiratory tract infections (RTIs) are the single most common infections seen in primary care, and a major contributor to the overall burden of disease worldwide. […] On average, adults will have between two and five RTIs annually, usually the common cold or upper respiratory infections. […] RTIs are also the most common indications for antibiotic prescribing, accounting for around 60% of all antibiotics prescribed in primary care, despite rarely providing patient benefit.

• #3 Summary – Respiratory Tract Infections – Antibiotic Prescribing – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK53636/

  Respiratory tract infection (RTI) is defined as any infectious disease of the upper or lower respiratory tract. Upper respiratory tract infections (URTIs) include the common cold, laryngitis, pharyngitis/tonsillitis, acute rhinitis, acute rhinosinusitis and acute otitis media. Lower respiratory tract infections (LRTIs) include acute bronchitis, bronchiolitis, pneumonia and tracheitis. Antibiotics are commonly prescribed for RTIs in adults and children in primary care. General practice consultation rates in England and Wales show that a quarter of the population will visit their GP because of an RTI each year (Ashworth et al. 2005). RTIs are the reason for 60% of all antibiotic prescribing in general practice, and this constitutes a significant cost to the NHS. Annual prescribing costs for acute cough alone exceed 15 million (Lindbaek 2006).

• #4 Respiratory tract infection – Wikipedia

  https://en.wikipedia.org/wiki/Respiratory_tract_infection

  Respiratory tract infections (RTIs) are infectious diseases involving the lower or upper respiratory tract. An infection of this type usually is further classified as an upper respiratory tract infection (URI or URTI) or a lower respiratory tract infection (LRI or LRTI). Lower respiratory infections, such as pneumonia, tend to be far more severe than upper respiratory infections, such as the common cold. […] Lower respiratory tract infections (LRIs) are generally more severe than upper respiratory infections. LRIs are the leading cause of death among all infectious diseases. […] Antibiotics are a medicine designed to treat bacterial infections that need a more severe treatment course; antibiotic use is not recommended for common bacterial infections as the immune system will resolve such infections. This medicine does not effectively treat a viral infection like sore throats, influenza, bronchitis, sinusitis and common respiratory tract infections.

• #5 An Overview of Common Respiratory Tract Infections | Ausmed

  https://www.ausmed.co.uk/cpd/articles/respiratory-tract-infections

  According to the World Health Organisation (2022), pneumonia accounts for 14% of deaths of children aged under five years of age. […] Sinusitis is an inflammation of the nasal sinuses. It generally presents as a secondary infection after a cold or untreated allergies. […] Bronchitis is an infection of the bronchi (the main airways of the lungs that branch off the trachea) that causes them to become inflamed and create more copious amounts of secretions than usual. […] Bronchitis is usually caused by the same viruses that cause colds and influenza. […] Tonsillitis is an inflammation of the tonsils, most commonly affecting children (though anyone can contract it). […] Laryngitis is the inflammation and irritation of the larynx (voice box), causing swelling of the vocal cords and a consequent distortion of the voice.

• #6 An Overview of Common Respiratory Tract Infections | Ausmed

  https://www.ausmed.com/learn/articles/respiratory-tract-infections

  According to the World Health Organisation (2022), pneumonia accounts for 14% of deaths of children aged under five years of age. […] Sinusitis is an inflammation of the nasal sinuses. It generally presents as a secondary infection after a cold or untreated allergies. […] Bronchitis is an infection of the bronchi (the main airways of the lungs that branch off the trachea) that causes them to become inflamed and create more copious amounts of secretions than usual. […] Bronchiolitis causes inflammation and congestion in the smallest airways (bronchioles). […] Tonsillitis is an inflammation of the tonsils, most commonly affecting children (though anyone can contract it). […] Laryngitis is the inflammation and irritation of the larynx (voice box), causing swelling of the vocal cords and a consequent distortion of the voice.

• #7 Respiratory Tract Infections – Antibiotic Prescribing – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK53632/

  Respiratory tract infection (RTI) is defined as any infectious disease of the upper or lower respiratory tract. Upper respiratory tract infections (URTIs) include the common cold, laryngitis, pharyngitis/tonsillitis, acute rhinitis, acute rhinosinusitis and acute otitis media. Lower respiratory tract infections (LRTIs) include acute bronchitis, bronchiolitis, pneumonia and tracheitis. Antibiotics are commonly prescribed for RTIs in adults and children in primary care. General practice consultation rates in England and Wales show that a quarter of the population will visit their GP because of an RTI each year (Ashworth et al. 2005). RTIs are the reason for 60% of all antibiotic prescribing in general practice, and this constitutes a significant cost to the NHS. Annual prescribing costs for acute cough alone exceed 15 million (Lindbaek 2006).

• #8 Respiratory tract infections (RTIs) in primary care: narrative review of C reactive protein (CRP) point-of-care testing (POCT) and antibacterial use in patients who present with symptoms of RTI | BMJ Open Respiratory Research

  https://bmjopenrespres.bmj.com/content/7/1/e000624

  GPs and patients report a good acceptability for a CRP POCT and economic evaluations show cost-effectiveness of CRP POCT over existing RTI management in primary care. […] POCTs increase diagnostic precision for GPs in the better management of patients with RTI. […] In the treatment of infections in the community (primary care) there has been some progress in reducing antimicrobial use in some countries but not in others, and there is a wide range of prescribing between individual European countries. […] In the UK around 50% of all general practice consultations for RTIs result in an antibiotic prescription, however there is a wide range of such prescribing (20% to 80%). […] This paper seeks to review the evidence for the use of CRP point-of-care testing (POCT) in reducing antimicrobial prescribing in primary care by prescribers who see patients presenting with symptoms of RTI.

• #9 Predisposing factors to acquisition of acute respiratory tract infections in the community: a systematic review and meta-analysis | BMC Infectious Diseases | Full Text

  https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-021-06954-3

  Preventing respiratory tract infections (RTIs) could have profound effects on quality of life, primary care workload, antibiotic prescribing and stewardship. […] We identified several modifiable risk factors associated with increased likelihood of acquiring RTIs in the community, including low BMI, contact with children and pets. […] Respiratory tract infections (RTIs) are the single most common infections seen in primary care, and a major contributor to the overall burden of disease worldwide. […] On average, adults will have between two and five RTIs annually, usually the common cold or upper respiratory infections. […] RTIs are also the most common indications for antibiotic prescribing, accounting for around 60% of all antibiotics prescribed in primary care, despite rarely providing patient benefit.

• #10 Diagnosis and Management of Recurrent Respiratory Tract Infections in Children: A Practical Guide

  https://brieflands.com/articles/apid-20283

  Respiratory tract infections (RTIs) affect children all over the world and are associated with significant morbidity and mortality. […] Children are particularly susceptible to RTIs due to the relative immaturity of their immune systems, and genetic factors (such as family history of atopy) and/or environmental factors (such as exposure to pollution and pathogens) also render certain populations more vulnerable to infection. […] The management of recurrent RTIs poses a tremendous challenge for physicians, who have a limited armamentarium with which to alleviate patients symptoms, treat their disease, and prevent recurrences. […] Though antibiotics are rarely indicated, they are often still used to treat RTIs. […] The resulting increase in bacterial resistance, the lack of treatment efficacy, and drug-related side effects all underscore the need for alternative strategies to manage recurrent RTIs.

• #11 An Overview of Common Respiratory Tract Infections | Ausmed

  https://www.ausmed.co.uk/cpd/articles/respiratory-tract-infections

  Respiratory tract infections (RTIs) are various infections that affect parts of the respiratory system, such as the sinuses, throat, airway or lungs (NHS 2024a). […] Lower RTIs are generally longer-lasting and more serious (NHS 2024a). […] RTIs are generally transmitted by direct contact with a contaminated surface or an infected person expelling droplets into the air via coughing, sneezing or talking (SA Health 2022). […] Pneumonia is an infection that causes inflammation of the alveoli (air sacs) in one or both lungs. The alveoli fill with secretions and fluid, decreasing the ability for oxygen to be transported across the tissue to adequately oxygenate vital organs. Patients may experience shortness of breath and may require oxygen therapy and ventilatory support. […] Pneumonia can be a serious and potentially fatal infection, with young children, older adults and those with pre-existing health conditions most at risk of complications such as pleurisy, lung abscess or sepsis.

• #12 Lower Respiratory Tract Infection | Riley Children’s Health

  https://www.rileychildrens.org/health-info/lower-respiratory-tract-infection

  A lower respiratory tract infection (RTI) occurs when there is an infection of the lungs, specifically in the lower airways. This infection is usually caused by a virus, but it can also be caused by bacteria or other less common organisms. […] Common lower RTIs in infants and young children include the flu, viral bronchiolitis and pneumonia. […] The main symptoms of a lower RTI are a persistent cough, fever and sometimes difficulty breathing. […] Treatment for a lower RTI caused by a virus includes drinking plenty of fluids and getting plenty of rest while the virus runs its course. […] If the infection is caused by bacteria, antibiotics may be prescribed.

• #13 Respiratory Tract Infection- Symptoms, Causes and Treatment

  https://www.careinsurance.com/blog/health-insurance-articles/check-if-you-have-respiratory-tract-infection-rti

  Lower Respiratory Tract Infections primarily affect the lower parts of the respiratory system, including the lungs, trachea and bronchi. One may suffer pneumonia (both bacterial and viral), bronchiolitis and bronchitis due to lower respiratory tract infection. […] Various microorganisms cause lower respiratory tract infections. The common causes include- […] Bacterial infection is one of the most common causes of LRTIs. These infections result in Chlamydia pneumoniae, streptococcus pneumoniae (pneumococcus), Mycoplasma pneumoniae, Legionella pneumophila and Haemophilus influenzae. […] Viral infection is another common cause of LRTIs after bacterial infection. Influenza viruses, respiratory syncytial virus (RSV), rhinoviruses (cause of the common cold), and coronaviruses (e.g., causing COVID-19) can lead to viral pneumonia and bronchitis. […] Not as common as viral and bacterial infections, fungal infections like pneumocystis jirovecii can harm the lower respiratory tract, especially in people with weak immune systems. […] A few LRTIs can be caused by unusual pathogens, such as mycobacterium tuberculosis (causing tuberculosis) and many parasites. […] Once exposed to pollutants, toxic gases or irritants, you become more prone to LRTIs. […] However, it’s important to know that the particular cause of an LRTI may vary, and the severity and treatment of the infection may differ depending on the microorganism. Proper diagnosis and appropriate medical care are essential for managing these infections.

• #14 Upper Respiratory and Lower Respiratory Tract Infections | Cystic Fibrosis News TodayEnvelope icon

  https://cysticfibrosisnewstoday.com/upper-respiratory-tract-infections-vs-lower-respiratory-tract-infections/

  Upper respiratory tract infection symptoms can include a sore throat, tonsillitis, laryngitis, sinus infection, sneezing and coughing, headache, fever, body ache, and fatigue. Lower respiratory tract infection symptoms can range from cough with mucus, chest pain while coughing, fevers and chills, body ache, fatigue, and shortness of breath. In the case of pneumonia, symptoms can also include disorientation, along with nausea and vomiting. […] On its own, cystic fibrosis (CF) can cause chronic symptoms such as excess mucus production, sinus inflammation (sinusitis), shortness of breath, and cough. In these patients, viral or bacterial infections can lead to lengthy respiratory illness, which is associated with a decline in lung function and a higher risk of death.

• #15

  https://consensus.app/questions/rti-infection-symptoms/

  Respiratory tract infections (RTIs) are a significant health concern globally, affecting various populations, including travelers, children, and individuals in crowded environments. Understanding the symptoms associated with RTIs is crucial for timely diagnosis and management. This article synthesizes findings from multiple studies to provide a comprehensive overview of RTI symptoms. […] Cough is the most frequently reported symptom of RTIs, particularly among travelers and children. Other common upper respiratory symptoms include nasal congestion, sore throat, and sneezing. These symptoms are often indicative of infections in the upper respiratory tract, which is the most common site for RTIs. […] Fever is another prevalent symptom, especially in children. It is often accompanied by general malaise, fatigue, and body aches. These symptoms can significantly impact daily activities, leading to absenteeism from school or work and increased healthcare visits.

• #16 Lower respiratory tract infection: Symptoms, diagnosis, and treatment

  https://www.medicalnewstoday.com/articles/324413

  Lower respiratory tract infections are any infections in the lungs or below the voice box. These include pneumonia, bronchitis, and tuberculosis. Symptoms of lower respiratory tract infections can vary. […] A lower respiratory tract infection can affect the airways, such as with bronchitis, or the air sacs at the end of the airways, as in the case of pneumonia. […] Symptoms of lower respiratory tract infections vary and depend on the severity of the infection. […] People who have lower respiratory tract infections will experience coughing as the primary symptom. […] Lower respiratory tract infections include: bronchitis, pneumonia, bronchiolitis, tuberculosis. […] Infections in the lower respiratory tract are primarily the result of: viruses, as with the flu or respiratory syncytial virus (RSV), bacteria, such as Streptococcus or Staphylococcus aureus, fungal infections, mycoplasma, which are neither viruses or bacteria but are small organisms with characteristics of both.

• #17 Respiratory Illness | Willis Urgent Care

  https://www.willisurgentcare.com/resipitorary-illness

  Respiratory tract infections (RTIs) include any infection of the sinuses, throat, airways, or lungs. […] Symptoms include coughing, sneezing, headaches, sore throat, muscle aches, and a stuffy or runny nose. […] A lower respiratory infection impacts the airways and lungs and can affect breathing. […] Usually, the most noticeable symptom of a lower RTI will be a cough, sometimes producing mucus and phlegm. […] Willis Urgent Care is open six days a week to evaluate, diagnose, and recommend appropriate treatment for both upper and lower respiratory tract infections. […] Most mild upper respiratory illnesses can be successfully treated at home. […] As with upper respiratory infections, common antibiotics are usually ineffective in lower respiratory infection treatment. […] A respiratory tract infection that is left untreated can spread to the lungs and affect the entire respiratory system.

• #18

  https://consensus.app/questions/rti-infection-symptoms/

  Dyspnea, or difficulty breathing, is a critical symptom observed in severe cases of RTIs. It is more commonly reported in young children and immunocompromised individuals. Rapid breathing and wheezing are also associated with higher illness severity scores in children. […] RTIs can also cause gastrointestinal symptoms such as nausea, vomiting, and diarrhea. These symptoms are linked to changes in the gut microbiota, which can occur during respiratory infections. The interplay between respiratory and gastrointestinal symptoms underscores the systemic impact of RTIs. […] RTIs often lead to disturbed sleep and reduced intake of food and fluids, particularly in children. These symptoms can prolong the recovery period and necessitate re-consultations with healthcare providers. Parents frequently administer over-the-counter medications like paracetamol and nasal sprays to manage these symptoms.

• #19 Respiratory tract infections | Healthify

  https://healthify.nz/health-a-z/r/respiratory-tract-infections

  See your healthcare provider as soon as possible if you, or someone you are caring for, has a respiratory tract infection and feels very unwell or symptoms get worse. […] Most upper RTIs are caused by a virus. […] However, severe or persistent sinus infections may need treatment with antibiotics. […] Your healthcare provider may need to prescribe a course of antibiotics if you have a lower RTI. […] To help you or the person you are caring for feel more comfortable and speed your recovery, take the following self-care steps: Get plenty of rest. […] Contact your healthcare provider immediately or call Healthline free on 0800 611 116 if you or your child have trouble breathing, have a high fever or show other signs that the infection is getting worse. […] Vaccinations can protect against certain viruses. […] If you keep getting RTIs or you’re at a high risk of getting one also ask your healthcare provider about the pneumococcal vaccine this helps prevent some types of pneumonia.

• #20 Respiratory tract infections (RTIs) – nose, throat & lungs

  https://www.nps.org.au/consumers/respiratory-tract-infections-rtis-nose-throat-and-lungs

  A sore throat will often get better by itself, as the bodys immune system can usually take care of the infection without any treatment. Antibiotics aren’t helpful for most people with a throat infection as most throat infections are caused by a virus, and antibiotics dont kill viruses. […] Whooping cough can be a very serious respiratory tract infection that is very easily spread (highly contagious). […] Whooping cough is treated with antibiotics, usually azithromycin, clarithromycin, or erythromycin. […] You should try to rest, drink plenty of water and non-alcoholic fluids, avoid smoking and exposure to cigarette smoke, inhale steam; this can help relieve a blocked nose. […] Adults and children older than 1 month can take paracetamol. Adults and children older than 3 months can take ibuprofen.

• #21 Respiratory tract infections (RTIs) in primary care: narrative review of C reactive protein (CRP) point-of-care testing (POCT) and antibacterial use in patients who present with symptoms of RTI | BMJ Open Respiratory Research

  https://bmjopenrespres.bmj.com/content/7/1/e000624

  Antimicrobial resistance (AMR) continues to be a global problem and continues to be addressed through national strategies to improve diagnostics, develop new antimicrobials and promote antimicrobial stewardship. […] Patients who attend general (ambulatory) practice with symptoms of respiratory tract infections (RTIs) are invariably assessed by some sort of clinical decision rule (CDR). […] A narrative review of the literature was undertaken to ascertain the value of C reactive protein (CRP) point-of-care testing (POCT) to guide antibacterial prescribing in adult patients presenting to general practitioner (GP) practices with symptoms of RTI. […] An overwhelming number of studies demonstrated that the use of CRP tests in patients presenting with RTI symptoms reduces index antibacterial prescribing.

• #22 Respiratory Tract Infection – Symptoms, Causes & Treatment | Medtronic (UK)

  https://www.medtronic.com/covidien/en-gb/clinical-solutions/respiratory-tract-infection.html

  Respiratory tract infection (RTI) refers to a range of infections that can occur in the upper and lower respiratory tract. […] Upper respiratory tract infections tend to be less severe than lower; for example tonsillitis, laryngitis and the common cold are URTIs, while bronchitis and pneumonia are LRTIs. […] Most Upper Respiratory Tract Infection (URTIs) are viral, but they can also be bacterial, fungal or helminth in origin. […] The seriousness of LRTIs necessitates rapid and accurate diagnosis of the infection in order to minimise its effects. […] Diagnosis of an RTI can be achieved through a physical examination, as outward signs and symptoms will generally be enough to indicate the presence of an infection. […] Courses of treatment for respiratory tract infections vary as greatly as the conditions that the umbrella term covers. A mild URTI will not require any medical intervention, while a serious LRTI will often lead to hospitalisation.

• #23 Understanding Respiratory tract infection: From Risk Factors to Home Remedies – The Kingsley Clinic

  https://thekingsleyclinic.com/both-upper-and-lower-airway/understanding-respiratory-tract-infection-from-risk-factors-to-home-remedies/

  Approximately 50% of respiratory tract infections are accompanied by fever, indicating that your body is fighting off an infection. […] Over 75% of individuals with upper respiratory tract infections experience nasal congestion. […] A sputum culture, used in about 15% of cases, involves examining the mucus that’s coughed up from the lungs to identify the organism causing the infection. […] Blood tests, conducted in approximately 30% of respiratory tract infections, can help determine the severity of the infection and how the body is responding to it. […] If all tests are negative but symptoms continue, it’s important not to ignore your symptoms. […] Antibiotics are prescribed for bacterial respiratory tract infections. […] Antivirals are used to treat some types of respiratory tract infections caused by viruses.

• #24 Respiratory Tract Infections and Laboratory Diagnostic Methods: A Review with A Focus on Syndromic Panel-Based Assays

  https://www.mdpi.com/2076-2607/10/9/1856

  The current algorithms for the laboratory diagnosis of RTIs rely on multiple approaches including gold-standard conventional methods, among which the traditional culture is the most used, and innovative ones such as molecular methods, mostly used to detect viruses and atypical bacteria. […] The epidemiological study of RTIs must keep up with the rapid changes in sociodemographic and climate dynamics and needs continuous updating in order to provide important tools for health policies of control and prevention. […] The use of syndromic panels for the detection of respiratory pathogens is associated with a radically reduced time-to-results and, in parallel, to increased detection of clinically relevant pathogens compared to the standard methods. […] Syndromic panels, if implemented wisely and interpreted cautiously, can improve antimicrobial use and patient outcomes through improved clinical decision, optimized laboratory workflow, and enhanced antimicrobial and laboratory stewardship.

• #25 C-reactive protein point-of-care testing for respiratory-tract infections in primary care

  https://acutecaretesting.org/en/articles/c-reactive-protein-point-of-care-testing-for-respiratory-tract-infections-in-primary-care

  Differentiating self-limiting from serious lower-respiratory-tract infections (LRTI) based on medical history and physical examination is challenging in primary care. […] The use of C-reactive protein (CRP) point-of-care testing as an additional diagnostic tool can enable FPs decrease antibiotics prescribing, without compromising patient recovery. […] The greatest value of CRP point-of-care testing in primary care lies in ruling out serious disease. […] Based on our findings the use of CRP point-of-care testing in respiratory-tract infections in primary care should only be advocated in LRTI and rhinosinusitis, and only when seeking additional diagnostic or prognostic information or to ensure further patient reassurance. […] Most oral antibiotics are prescribed in primary care. […] In general, antibiotics overprescribing for lower-respiratory-tract infections (LRTI) in primary care can broadly be related to two distinct factors within the RTI consultation: Clinicians diagnostic uncertainty in differentiating serious from self-limiting disease and Patient-related factors during the time-pressured RTI consultation.

• #26 Respiratory Infections Tests and Diagnostics

  https://www.biomerieux.com/corp/en/our-offer/point-of-care/patient-condition/respiratory-infections-tests-and-diagnostics.html

  Taken as a whole, respiratory diseases are responsible for 2.377 million deaths worldwide each year. […] Although very frequent, RTIs remain a challenge for clinicians as they have various clinical presentations / severities and are caused by numerous microbiological agents (bacteria, virus, fungus, parasite). […] The clinical assessment is frequently not sufficient to predict the etiological agent, for LRTI. Timely and accurate diagnosis is critical to select the appropriate therapy. […] Identification of the pathogen(s) and accuracy of the diagnosis is critical. […] The syndromic approach marks a significant breakthrough in improving patient care and facilitating appropriate antibiotic treatments. […] After initial risk assessment and administration of empiric therapy, pathogen detection, identification, and susceptibility testing provide critical information about whether the initial therapy needs to be adjusted. This is especially important because a patient may have an infection that is resistant to certain antibiotics, and because it allows physicians to optimize therapy. […] It is critically important that clinicians assess when to discontinue antibiotics. VIDAS BRAHMS PCT aids in decision making on antibiotic discontinuation for patients with suspected or confirmed bacterial infections.

• #27 Management of respiratory tract infections in children | NRR

  https://www.dovepress.com/management-of-respiratory-tract-infections-in-children-peer-reviewed-fulltext-article-NRR

  Respiratory tract infections (RTIs) in children are one of the most common reasons for parents consulting health professionals. Most RTIs are self-limiting viral illnesses that will resolve with time and supportive management. However, it is important for the health professional to identify any RTI that may have more serious implications for the child and require medical intervention. […] With the expanding role of nurses in ambulatory settings, many children are now being seen by health professionals other than doctors, (eg, advanced nurse practitioners), some of whom are trained in pediatrics while others have limited knowledge of nursing sick children. It is therefore vital that these professionals remain aware of any risk factors and that they can recognize „red flags” in a sick child rapidly and escalate further management appropriately.

• #28 Respiratory Infections in Children: An Updated Review of Pathophysiology, Diagnosis, Treatment, Biochemical Aspects, and Nursing Interventions

  https://www.jmchemsci.com/article_211142.html

  Respiratory tract infections (RTIs) are among the most common and significant health concerns in children, contributing to substantial morbidity and mortality worldwide, particularly in low- and middle-income countries. Effective management of RTIs in children requires a multifaceted approach, incorporating antimicrobial or antiviral therapy, supportive care, and preventive measures such as vaccination and hygiene promotion. Nursing interventions play a pivotal role in monitoring and managing these infections, particularly in ensuring early detection of complications and providing family-centered care. […] Nursing interventions are essential for symptom management, patient comfort, and preventing the spread of infection. Early intervention and holistic care approaches can improve outcomes for affected children.

• #29 Respiratory Infections in Children: An Updated Review of Pathophysiology, Diagnosis, Treatment, Biochemical Aspects, and Nursing Interventions

  https://www.jmchemsci.com/article_211142.html

  The nursing interventions for Sarah focused on optimizing respiratory function and ensuring systemic stability. Positioning the infant to maximize chest expansion and maintain airway patency was prioritized to enhance ventilation. Continuous monitoring of vital signs, including respiratory rate, oxygenation, and circulation, allowed for prompt identification of abnormalities. […] Parental education and involvement were integral to Sarah’s care. Parents were informed about the nature of acute respiratory tract infections, including their etiology and symptoms, as well as strategies to enhance ventilation and clear secretions, such as sitting the infant upright and performing chest physiotherapy or nasal suctioning. […] The anticipated outcomes for managing acute respiratory tract infections involve ensuring both effective care delivery and parental understanding. Parents should demonstrate a comprehensive understanding of the condition, including its nature, causes, and management strategies. […] Key nursing interventions include ensuring adequate hydration, controlling body temperature, promoting respiratory comfort, and providing psychological support to both the child and their family.

• #30 Respiratory Infections in Children: An Updated Review of Pathophysiology, Diagnosis, Treatment, Biochemical Aspects, and Nursing Interventions

  https://www.jmchemsci.com/article_211142.html

  The nursing interventions for Sarah focused on optimizing respiratory function and ensuring systemic stability. Positioning the infant to maximize chest expansion and maintain airway patency was prioritized to enhance ventilation. Continuous monitoring of vital signs, including respiratory rate, oxygenation, and circulation, allowed for prompt identification of abnormalities. […] Parental education and involvement were integral to Sarah’s care. Parents were informed about the nature of acute respiratory tract infections, including their etiology and symptoms, as well as strategies to enhance ventilation and clear secretions, such as sitting the infant upright and performing chest physiotherapy or nasal suctioning. […] The anticipated outcomes for managing acute respiratory tract infections involve ensuring both effective care delivery and parental understanding. Parents should demonstrate a comprehensive understanding of the condition, including its nature, causes, and management strategies. […] Key nursing interventions include ensuring adequate hydration, controlling body temperature, promoting respiratory comfort, and providing psychological support to both the child and their family.

• #31 Management of respiratory tract infections in children | NRR

  https://www.dovepress.com/management-of-respiratory-tract-infections-in-children-peer-reviewed-fulltext-article-NRR

  Nurses have a vital role, not only in administering medications and supporting other medical interventions, but also in supporting the child and family over the period of illness. The education of the parents and the child, in some instances, about prevention and avoidance to reduce the risks of any further RTIs must be addressed, including immunization and smoking cessation. […] Nurses have an important role in managing children with RTIs, both in the community and in the hospital environment. However, this role changes depending on the health infrastructure in different countries. In the UK, nurses are involved in managing children both in primary and secondary care, so are well placed for managing RTIs, one of the most common illnesses in childhood. […] In primary care, practice nurses, community nurses, health visitors, school nurses, and pediatric nurse practitioners can often decide on further management and referral.

• #32 Management of respiratory tract infections in children | NRR

  https://www.dovepress.com/management-of-respiratory-tract-infections-in-children-peer-reviewed-fulltext-article-NRR

  Nurses also play an extended role in supporting parents who may be worried and anxious about their child’s symptoms, by ensuring appropriate follow-up arrangements are provided, and that written and verbal safety net explanations are given and understood with regard to what should be done if the child deteriorates at home. […] The role of nurse specialists is being increasingly recognized in some areas of respiratory care, and needs further expansion both in primary and secondary care. Included in this expanding role is the value of health promotion to educate families, thereby improving uptake of immunization, which has a role in preventing serious RTIs, such as epiglottitis and pneumonias.

• #33 Respiratory tract infections (RTIs)

  https://www.nhs.uk/conditions/respiratory-tract-infection/

  Respiratory tract infections (RTIs) are infections of parts of the body involved in breathing, such as the sinuses, throat, airways or lungs. […] Most respiratory tract infections (RTIs) pass within 1 to 2 weeks. You can usually treat your symptoms at home. […] A pharmacist can suggest treatments to help relieve your symptoms, such as decongestants and nasal sprays. […] Treatment for a respiratory tract infection (RTI) will depend on the cause of your infection. […] Antibiotics are only used to treat bacterial infections. They’re not used for treating viral infections because they do not work for this type of infection. […] To reduce the chance of passing an RTI on to others: cover your mouth when you cough or sneeze, wash your hands regularly, throw away used tissues immediately.

• #34 Lower respiratory tract infection: Symptoms, diagnosis, and treatment

  https://www.medicalnewstoday.com/articles/324413

  Risk factors that make a person more likely to develop a lower respiratory tract infection include: a recent cold or flu, a weakened immune system, being more than 65 years old, being under 5 years old, recent surgery. […] A doctor will usually diagnose a lower respiratory infection during an exam and after discussing the symptoms a person has and how long they have been present. […] Some lower respiratory tract infections go away without needing treatment. […] In other cases, a doctor may prescribe additional treatment. This may include antibiotics for bacterial infections, or breathing treatments, such as an inhaler. […] Very young children and infants may need more treatment than older children or healthy adults. […] Recovery time for a lower respiratory tract infection varies from person to person.

• #35 Respiratory tract infections (RTIs) – nose, throat & lungs

  https://www.nps.org.au/consumers/respiratory-tract-infections-rtis-nose-throat-and-lungs

  A sore throat will often get better by itself, as the bodys immune system can usually take care of the infection without any treatment. Antibiotics aren’t helpful for most people with a throat infection as most throat infections are caused by a virus, and antibiotics dont kill viruses. […] Whooping cough can be a very serious respiratory tract infection that is very easily spread (highly contagious). […] Whooping cough is treated with antibiotics, usually azithromycin, clarithromycin, or erythromycin. […] You should try to rest, drink plenty of water and non-alcoholic fluids, avoid smoking and exposure to cigarette smoke, inhale steam; this can help relieve a blocked nose. […] Adults and children older than 1 month can take paracetamol. Adults and children older than 3 months can take ibuprofen.

• #36 Upper Respiratory Tract Infection Medication: Penicillins, Natural, Penicillins, Amino, Cephalosporins, First Generation, Cephalosporins, Second Generation, Cephalosporins, Third Generation, Macrolides, Analgesics, Other, NSAIDs, Anticholinergics, Respira

  https://emedicine.medscape.com/article/302460-medication

  Cough and cold medicines should be used with caution in children younger than 2 years because serious adverse reactions and fatalities have occurred with over-the-counter preparations. […] Decongestants and antihistamines should be used with caution in children younger than 2 years because serious adverse reactions and fatalities have occurred with over-the-counter cough and cold preparations. In 2008, the Consumer Healthcare Products Association modified many over-the-counter cough and cold product labels to state „do not use” in children younger than 4 years.

• #37 Respiratory Tract Infections – Antibiotic Prescribing – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK53632/

  There is evidence from randomised placebo-controlled trials (RCTs) that antibiotics have limited efficacy in treating a large proportion of RTIs in adults and children (see section 2). These include acute otitis media (AOM), acute cough/acute bronchitis, acute sore throat/acute pharyngitis/acute tonsillitis, acute rhinosinusitis and the common cold. These conditions are largely self-limiting and complications are likely to be rare if antibiotics are withheld. Therefore, these five common RTIs are the focus of this guideline. The inappropriate prescribing of antibiotics has the potential to cause drug-related adverse events, escalate the prevalence of antibiotic-resistant organisms in the community and increase primary care consultation rates for minor illness (Standing Medical Advisory Committee 1998).

• #38

  https://bpac.org.nz/2019/rti.aspx

  Antibiotics may be considered for people with a suspected or confirmed bacterial RTI who are at high risk of complications, e.g. those with immunosuppression, or in specific clinical scenarios, e.g. all cases of bacterial pneumonia, bilateral acute otitis media in children aged under two years. […] Always consider the possibility of meningococcal disease in people presenting with influenza-like illness; ensure that patients and/or caregivers know when to seek urgent medical advice. […] Throat swabs and antibiotic treatment for Group A Streptococcus infection are only indicated for people who present with sore throat who have risk factors for rheumatic fever. […] Most RTIs are caused by viruses and are self-limiting, and antibiotics are not appropriate. However, in some cases it is difficult to be certain if an infection is viral or bacterial, who would most benefit from antibiotic treatment and the likelihood of complications.

• #39

  https://bpac.org.nz/2019/rti.aspx

  The threshold for considering antibiotics for patients with a suspected or confirmed bacterial RTI should be low for those who are at high risk of complications due to compromised immune function, such as people with: immune suppression, significant heart, lung, renal, liver, metabolic, autoimmune or neuromuscular disease, e.g. heart failure, COPD, bronchiectasis, severe asthma, diabetes. […] Antibiotics are not required in most cases unless Group A Streptococcus (GAS) positive and at high risk of rheumatic fever. […] Antibiotics are usually unnecessary as most infections are self-limiting.

• #40 Summary – Respiratory Tract Infections – Antibiotic Prescribing – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK53636/

  Three different antibiotic management strategies can be used for patients with RTIs who present in primary care and other first face-to-face contact healthcare settings (such as emergency departments and walk-in centres): no antibiotic prescribing; delayed (or deferred) antibiotic prescribing (in which an antibiotic prescription is written for use at a later date should symptoms worsen); and immediate antibiotic prescribing. The decision agreed between healthcare professional and patient depends on both the healthcare professionals assessment of the risk of complications if antibiotics are withheld and the patients expectations regarding an antibiotic prescription (Britten N et al. 2008; Butler et al. 1998). Perceived advantages of delayed prescribing as a strategy over no prescribing are that it offers a safety net for the small proportion of patients who develop a complication, and that a patient expecting antibiotics may be more likely to agree with this course of action rather than with no prescribing. Delayed prescribing has therefore been advocated as an important management strategy to reduce inappropriate antibiotic prescribing (Little 2005).

• #41 Respiratory Tract Infection- Symptoms, Causes and Treatment

  https://www.careinsurance.com/blog/health-insurance-articles/check-if-you-have-respiratory-tract-infection-rti

  Lower respiratory infection symptoms may vary according to the severity of one’s condition. Here are the symptoms of both less severe and more severe conditions- […] In severe infection, symptoms are- […] You may not need treatment as lower respiratory tract infection goes away on its own in a few cases. […] However, you can treat these less severe infections at home with the help of the following practices mentioned below- […] In a few cases, your doctor may recommend additional treatment that includes antibiotics for bacterial infections or an inhaler to treat breathing. You may also have to visit the hospital for IV fluids and antibiotics. […] An upper respiratory infection affects the upper part of your respiratory system, consisting of the nose, sinuses, mouth, throat, pharynx, and larynx (voice box) in the upper part of the respiratory system. […] Viruses and bacteria cause upper respiratory tract infection and is contagious. When someone is infected with the URTI, coughs and sneezes, the droplets of saliva may contaminate surfaces that other people touch and then touch their eyes, nose, or mouth, which may develop the infection.

• #42 Understanding Respiratory tract infection: From Risk Factors to Home Remedies – The Kingsley Clinic

  https://thekingsleyclinic.com/both-upper-and-lower-airway/understanding-respiratory-tract-infection-from-risk-factors-to-home-remedies/

  Oxygen therapy involves supplying extra oxygen to the lungs through a mask or nasal prongs. […] Home remedies and lifestyle changes can also be helpful in managing respiratory tract infections. […] If home remedies aren’t effective, or if symptoms such as high fever, severe chest pain, difficulty breathing, or confusion occur, you should seek medical help immediately. […] Regular check-ups are also key in managing your condition and preventing complications. […] Early diagnosis and treatment are crucial in managing these infections effectively and preventing complications.

• #43 Lower respiratory tract infection: Symptoms, diagnosis, and treatment

  https://www.medicalnewstoday.com/articles/324413

  According to the American Lung Association, a healthy young adult can recover from a lower respiratory tract infection, such as pneumonia, in around 1 week. […] A person can take many steps to prevent getting a lower respiratory tract infection, including: washing their hands frequently, avoiding touching the face with unwashed hands, staying away from people with respiratory symptoms, cleaning and disinfecting surfaces regularly, getting vaccines, such as the pneumococcal vaccine and MMR vaccine, getting a flu shot every year, avoiding known irritants, such as chemicals, fumes, and tobacco. […] Most lower respiratory tract infections are uncomplicated. However, when complications occur, they can be very serious. […] Complications of lower respiratory tract infections can include: congestive heart failure, respiratory failure, respiratory arrest, sepsis, which is a blood infection that can lead to organ shutdown, lung abscesses. […] Most healthy people make a full recovery from uncomplicated lower respiratory tract infections. However, complications can have long-term effects.

• #44 An Overview of Common Respiratory Tract Infections | Ausmed

  https://www.ausmed.co.uk/cpd/articles/respiratory-tract-infections

  Respiratory tract infections (RTIs) are various infections that affect parts of the respiratory system, such as the sinuses, throat, airway or lungs (NHS 2024a). […] Lower RTIs are generally longer-lasting and more serious (NHS 2024a). […] RTIs are generally transmitted by direct contact with a contaminated surface or an infected person expelling droplets into the air via coughing, sneezing or talking (SA Health 2022). […] Pneumonia is an infection that causes inflammation of the alveoli (air sacs) in one or both lungs. The alveoli fill with secretions and fluid, decreasing the ability for oxygen to be transported across the tissue to adequately oxygenate vital organs. Patients may experience shortness of breath and may require oxygen therapy and ventilatory support. […] Pneumonia can be a serious and potentially fatal infection, with young children, older adults and those with pre-existing health conditions most at risk of complications such as pleurisy, lung abscess or sepsis.

• #45 Safety of reduced antibiotic prescribing for self limiting respiratory tract infections in primary care: cohort study using electronic health records | The BMJ

  https://www.bmj.com/content/354/bmj.i3410

  Objective To determine whether the incidence of pneumonia, peritonsillar abscess, mastoiditis, empyema, meningitis, intracranial abscess, and Lemierres syndrome is higher in general practices that prescribe fewer antibiotics for self limiting respiratory tract infections (RTIs). […] General practices that adopt a policy to reduce antibiotic prescribing for RTIs might expect a slight increase in the incidence of treatable pneumonia and peritonsillar abscess. No increase is likely in mastoiditis, empyema, bacterial meningitis, intracranial abscess, or Lemierres syndrome. […] About 60% of antibiotics prescribed in primary care are for respiratory tract infections (RTIs). […] Antibiotic treatment of RTIs offers negligible benefit to affected patients and is often associated with side effects.

• #46 Safety of reduced antibiotic prescribing for self limiting respiratory tract infections in primary care: cohort study using electronic health records | The BMJ

  https://www.bmj.com/content/354/bmj.i3410

  Guidance in the United Kingdom recommends that either a no antibiotic prescribing strategy or a delayed antibiotic prescribing strategy should be agreed for most patients with RTIs. […] Clinical concern that reducing antibiotic use might increase the risk of complications following RTIs might be realistic. […] We evaluated the safety of a policy to reduce antibiotic prescribing for RTIs in primary care and the incidence of pneumonia, peritonsillar abscess, mastoiditis, empyema, meningitis, intracranial abscess, and Lemierres syndrome. […] The results show that general practices prescribing fewer antibiotics for RTIs may expect to have a slightly higher incidence of pneumonia and peritonsillar abscess than higher prescribing general practices. […] If a general practice with an average list size of 7000 patients reduced the proportion of RTI consultations with antibiotics prescribed by 10%, it might encounter about one additional case of pneumonia each year and one additional case of peritonsillar abscess each decade. […] The number of cases of mastoiditis, empyema, bacterial meningitis, intracranial abscess, and Lemierres syndrome are not expected to increase.

• #47 Lower respiratory tract infection: Symptoms, diagnosis, and treatment

  https://www.medicalnewstoday.com/articles/324413

  According to the American Lung Association, a healthy young adult can recover from a lower respiratory tract infection, such as pneumonia, in around 1 week. […] A person can take many steps to prevent getting a lower respiratory tract infection, including: washing their hands frequently, avoiding touching the face with unwashed hands, staying away from people with respiratory symptoms, cleaning and disinfecting surfaces regularly, getting vaccines, such as the pneumococcal vaccine and MMR vaccine, getting a flu shot every year, avoiding known irritants, such as chemicals, fumes, and tobacco. […] Most lower respiratory tract infections are uncomplicated. However, when complications occur, they can be very serious. […] Complications of lower respiratory tract infections can include: congestive heart failure, respiratory failure, respiratory arrest, sepsis, which is a blood infection that can lead to organ shutdown, lung abscesses. […] Most healthy people make a full recovery from uncomplicated lower respiratory tract infections. However, complications can have long-term effects.

• #48 Respiratory tract infections (RTIs)

  https://www.nhs.uk/conditions/respiratory-tract-infection/

  Respiratory tract infections (RTIs) are infections of parts of the body involved in breathing, such as the sinuses, throat, airways or lungs. […] Most respiratory tract infections (RTIs) pass within 1 to 2 weeks. You can usually treat your symptoms at home. […] A pharmacist can suggest treatments to help relieve your symptoms, such as decongestants and nasal sprays. […] Treatment for a respiratory tract infection (RTI) will depend on the cause of your infection. […] Antibiotics are only used to treat bacterial infections. They’re not used for treating viral infections because they do not work for this type of infection. […] To reduce the chance of passing an RTI on to others: cover your mouth when you cough or sneeze, wash your hands regularly, throw away used tissues immediately.

• #49 Respiratory tract infections | Healthify

  https://healthify.nz/health-a-z/r/respiratory-tract-infections

  See your healthcare provider as soon as possible if you, or someone you are caring for, has a respiratory tract infection and feels very unwell or symptoms get worse. […] Most upper RTIs are caused by a virus. […] However, severe or persistent sinus infections may need treatment with antibiotics. […] Your healthcare provider may need to prescribe a course of antibiotics if you have a lower RTI. […] To help you or the person you are caring for feel more comfortable and speed your recovery, take the following self-care steps: Get plenty of rest. […] Contact your healthcare provider immediately or call Healthline free on 0800 611 116 if you or your child have trouble breathing, have a high fever or show other signs that the infection is getting worse. […] Vaccinations can protect against certain viruses. […] If you keep getting RTIs or you’re at a high risk of getting one also ask your healthcare provider about the pneumococcal vaccine this helps prevent some types of pneumonia.

• #50 Respiratory tract infections (RTIs)

  https://www.nhs.uk/conditions/respiratory-tract-infection/

  If you keep getting respiratory tract infections or you’re at a high risk of getting one (for example, because you’re over the age of 65 or have a serious long-term health condition), you should ask a GP about the annual flu vaccine. […] There are several different types of respiratory tract infection (RTI). They’re usually grouped into upper RTIs and lower RTIs.

• #51 Predisposing factors to acquisition of acute respiratory tract infections in the community: a systematic review and meta-analysis | BMC Infectious Diseases | Full Text

  https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-021-06954-3

  This systematic review and meta-analysis aims to identify the factors increasing and decreasing the risk of acquiring respiratory infections in communities within OECD member countries. […] Our rigorously conducted systematic review meta-analysis suggests chronic liver and renal conditions, previous hospitalisation, low BMI, male sex, and contact with children and pets all increase the likelihood of people living in OECD member countries acquiring a respiratory infection. […] We identified several risk factors associated with increased likelihood of individuals acquiring RTIs in the community, including chronic liver disease, low BMI, and contact with children and pets. Modification of risk factors and targeting prevention to vulnerable groups could reduce morbidity, mortality and antibiotic use associated with RTI, the most common type of infection worldwide.

• #52 Reducing uncertainty in managing respiratory tract infections in primary care | British Journal of General Practice

  https://bjgp.org/content/60/581/e466

  The shared international resource of antimicrobial sensitivity is diminishing and all prescribers have a stewardship responsibility. […] Ongoing research into identifying patients likely to benefit from antibiotic treatment and identifying those who can safely be managed without antibiotic treatment is an urgent priority.

• #53 Reducing uncertainty in managing respiratory tract infections in primary care | British Journal of General Practice

  https://bjgp.org/content/60/581/e466

  The 2008 National Institute for Clinical Excellence (NICE) guidelines recommend no antibiotics or delayed antibiotics for most patients with RTI. […] Differentiating the few patients at higher risk from a complicated course from the majority who will recover uneventfully remains a challenge, and antibiotics continue to be widely overused. […] Clinical prediction rules, identification of at risk groups, near-patient tests, and better communication regarding uncertainty can all help target antibiotics to those most likely to benefit. […] The NICE guidelines identify those at increased risk of complications from RTIs. […] Non-antibiotic treatments for RTIs are summarised in Box 7. […] Antibiotics are more likely to be prescribed when patients expect them. […] Delayed prescribing can reduce antibiotic use for acute respiratory infections without harming patients.

• #54 RAMR – Volumen 16, Número 4 – Incidence of respiratory tract infections in tracheostomized patients hospitalized in a weaning and rehabilitation center

  https://www.ramr.org/articulos/volumen_16_numero_4/articulos_originales/articulos_originales_incidence_of_respiratory_tract_infections_in_tracheostomized_patients.php

  For the first time in our setting, it was possible to determine the incidence of RTI in tracheostomized patients and the most common pathogens, although comparison with other WRCs is needed. […] Patients with certain neurologic diseases are at increased risk for RTI. […] The incidence rate and the cumulative incidence of RTI were similar to those reported by Scheinhorn et al., who conducted a multicenter study in 1,419 patients receiving prolonged MV admitted to 23 WRC. […] The highest albumin values in our sample were associated with a lower risk for development of RTI, a finding consistent with that reported by George et al., who found that serum albumin below normal values was a risk factor for the development of infection, which suggests impaired host status, a predisposing factor for infection.

• #55 Respiratory tract infections (RTIs) in primary care: narrative review of C reactive protein (CRP) point-of-care testing (POCT) and antibacterial use in patients who present with symptoms of RTI | BMJ Open Respiratory Research

  https://bmjopenrespres.bmj.com/content/7/1/e000624

  A thematic analysis of data from preintervention and postintervention patients and healthcare workers found widespread positive attitudes towards CRP POCT among patients and healthcare workers. […] The use of CRP POCT may reduce unnecessary antibiotic prescribing (which carries a risk of adverse effects and the development of antibiotic resistance), but seems unlikely in the absence of a funded implementation programme. […] There is overwhelming evidence that CRP POCT can offer a significant strengthening of primary care clinicians diagnostic precision in addressing whether or not a patient presenting with symptoms of RTI needs antibiotics or not.

• #56 Diagnosis and Management of Recurrent Respiratory Tract Infections in Children: A Practical Guide

  https://brieflands.com/articles/apid-20283

  Pediatric RTIs require multiple medical visits and time spent at home for the patient and their caregivers, leading to school and/or work absenteeism and affecting the quality of life. […] The widespread use of antibiotics for the treatment of RTIs is associated with adverse effects for the patient and a growing rate of clinical failure due to the rise of antibiotic resistance. […] Recurrent infections of the respiratory tissues may result in virus-induced immune dysfunction and can lead to a vicious cycle of recurrent RTIs with bacterial super-infections, exacerbation of cough, and increased risk of asthma development. […] Raising awareness among parents of the modifiable risk factors for recurrent RTIs can play a large role in prevention. […] Preventive strategies are moving to the forefront as part of a holistic effort to minimize the incidence of RTIs and limit their sequelae. […] Well-established immunomodulators such as OM-85 could play a key role in augmenting the limited armamentarium for physicians regularly facing the problem of recurrent pediatric respiratory infections.

• #57 Call to reduce repeat 'within-episode’ antibiotic prescriptions for respiratory tract infections in primary care

  https://medicalxpress.com/news/2024-04-episode-antibiotic-prescriptions-respiratory-tract.html

  Previous research has shown that for most child and adult patients with chest infections, particularly those without chronic lung disease, even a single antibiotic course is unlikely to have clinical benefit, raising concerns about antibiotic overuse and resistance. […] Twelve factors associated with repeat prescriptions included frequent RTI-related GP visits and prior repeat within-episode RTI antibiotic prescriptions. Age was a significant determinant, with both young children (< 2 years) and older adults (65+) more likely to receive repeat prescriptions. [...] Arief Lalmohamed, senior lecturer at University Medical Center Utrecht and lead author of the study, said, "Repeat within-episode antibiotic use accounts for a significant proportion of all antibiotics prescribed for RTIs. In light of our findings, it's clear that antimicrobial stewardship interventions must extend beyond initial antibiotic prescriptions to address within-episode repeats."

• #58 Post-consultation acute respiratory tract infection recovery: a latent class-informed analysis of individual patient data | British Journal of General Practice

  https://bjgp.org/content/73/728/e196

  This study found that older age, greater baseline severity, longer prior duration of illness, and presence of lung disease predicted membership to trajectories with slower symptom recovery. Immediate antibiotic prescribing was associated with lower odds of slower recovery (that is, those prescribed immediate antibiotics were more likely to recover faster). Trajectories with slower recovery had higher odds of re-consultation and admission to hospital. […] Clinicians can advise patients with severe baseline severity, prior illness duration lasting 7 days, cough, or lung disease that they are likely to experience longer duration of symptoms (10 days and up to 28 days) and should be alerted to the higher risk of admission to hospital. […] In conclusion, patients presenting with more severe and longer pre-consultation symptoms and chronic lung disease should be advised they are more likely to experience longer post-consultation illness durations, which can last up to 28 days, and that overall recovery rates are similar with and without antibiotics.

• #59 RAMR – Volumen 16, Número 4 – Incidence of respiratory tract infections in tracheostomized patients hospitalized in a weaning and rehabilitation center

  https://www.ramr.org/articulos/volumen_16_numero_4/articulos_originales/articulos_originales_incidence_of_respiratory_tract_infections_in_tracheostomized_patients.php

  Objectives: To describe the incidence of respiratory tract infections (RTIs) in tracheostomized patients hospitalized in a weaning and rehabilitation center (WRC) and to identify risk factors (RFs) for the development of RTI. […] A total of 167 patients were included, with 73 RTI episodes being recorded in 46 patients (27.5%). Cumulative incidence was 27.5%, and incidence rate was 2.22 episodes per 1,000 days of stay. […] The lowest albumin values proved to be a RF for the development of RTI (p 0.001, odds ratio [OR] 5.82, confidence interval [CI] 2.08-16.2). […] Diagnoses of stroke (p 0.025, OR 3.45, CI 1.16-10.2), Parkinson (p 0.011, OR 18.9, CI 1.93-185) or amyotrophic lateral sclerosis (ALS) (p 0.013, OR 6.34, IC 1.47-27.2) on admission were established as risk factors for the development of RTI.

• #60 RAMR – Volumen 16, Número 4 – Incidence of respiratory tract infections in tracheostomized patients hospitalized in a weaning and rehabilitation center

  https://www.ramr.org/articulos/volumen_16_numero_4/articulos_originales/articulos_originales_incidence_of_respiratory_tract_infections_in_tracheostomized_patients.php

  The relationship between swallow tests and the incidence of RTI could not be analyzed, as during the two-year study period patients in the control group were going through different stages of their swallow tests. […] Of the pathogens recovered by bacteriological examination, Pseudomonas aeruginosa proved to be the most common causative organism, as reported in other studies. […] The association found between albumin values and the subsequent development of RTI may be more related to an incidental finding than to a significant clinical difference.

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