1
|
Rzepka A, Mania A. Positive Point-of-Care Influenza Test Significantly Decreases the Probability of Antibiotic Treatment during Respiratory Tract Infections in Primary Care. Diagnostics (Basel) 2023; 13:2031. [PMID: 37370926 PMCID: PMC10297189 DOI: 10.3390/diagnostics13122031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/06/2023] [Accepted: 06/10/2023] [Indexed: 06/29/2023] Open
Abstract
This study aimed to analyse clinical and laboratory findings in primary care patients with respiratory tract infections to distinguish the group more likely to receive antibiotic treatment. The study group consisted of 631 patients (264 males; 367 females) with a median age of 48 years (IQR 36-63 years). Analysed groups included patients treated with antibiotics (n = 269 patients; 43%) and those who recovered without antibiotic treatment (n = 362 patients; 57%). Patients receiving antibiotics were older (median 51 vs. 47 years; p = 0.008) and more commonly developed fever (77% vs. 25%, p < 0.0001) and cough (63% vs. 30%; p = 0.0014). Moreover, they more frequently presented wheezing and crackles upon physical examination (28% vs. 4% and 9% vs. 0.3%; p < 0.0001 and p < 0.0001, respectively). They also had more comorbidities and came to more follow-up visits (median of 4 vs. 3 and 2 vs. 1, p < 0.0001 and p < 0.0001, respectively). Patients receiving symptomatic therapy more often had positive point-of-care tests (POCTS)-20% vs. 7%; p = <0.0001. Multivariate analysis in our cohort found comorbidities complexity (odds ratio-OR 2.62; 95% confidence interval-1.54-4.46), fever (OR 32.59; 95%CI 19.15-55.47), crackles (OR 26.35; 95%CI 2.77-250.81) and the number of visits (OR 4.15; 95%CI 2.39-7.20) as factors increasing the probability of antibiotic treatment. Positive influenza POCTS reduced the risk of antibiotic therapy (OR 0.0015; 95%CI 0.0001-0.0168).
Collapse
Affiliation(s)
- Aneta Rzepka
- Medicus Primary Health Care Centre, Magdalena Kurnatowska, ul. Starogostyńska 9, 63-800 Gostyń, Poland;
| | - Anna Mania
- Department of Infectious Diseases and Child Neurology, Poznan University of Medical Sciences, 60-572 Poznań, Poland
| |
Collapse
|
2
|
Llor C, Moragas A, Ouchi D, Monfà R, Garcia-Sangenís A, Gómez-Lumbreras A, Pera H, Pujol J, Morros R. Effectiveness of antitussives, anticholinergics, and honey versus usual care in adults with uncomplicated acute bronchitis: a multiarm randomized clinical trial. Fam Pract 2022; 40:407-413. [PMID: 36239199 PMCID: PMC9619792 DOI: 10.1093/fampra/cmac112] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Despite the frequent use of symptomatic therapies in cough, evidence of their benefits is lacking. OBJECTIVE We compared the effectiveness of 3 symptomatic therapies and usual care in acute bronchitis. METHODS Multicenter, pragmatic, multiarm parallel group, open randomized trial in primary care (ClinicalTrials.gov, Identifier: NCT03738917) was conducted in Catalonia. Patients ≥18 with uncomplicated acute bronchitis, with cough<3 weeks as the main symptom, scoring ≥4 in either daytime or nocturnal cough (7-point Likert scale), were randomized to usual care, dextromethorphan 15 mg t.i.d., ipratropium bromide inhaler 20 µg 2 puffs t.i.d, or 30 mg of honey t.i.d., all taken for up to 14 days. The main outcome measure was the number of days with moderate-to-severe cough. A symptom diary was given. A second visit was scheduled at days 2-3 for assessing evolution, with 2 more visits at days 15 and 29 for clinical assessment, evaluation of adverse effects, re-attendance, and complications. RESULTS We failed to achieve the sample size scheduled due to the COVID-19 pandemic. We finally recruited 194 patients. The median number of days with moderate-to-severe cough (score ≥ 3) in the usual care arm was 5 (interquartile range [IQR], 4, 8.75), 5 in the ipratropium bromide arm (IQR, 3, 8), 5 in the dextromethorphan arm (IQR, 4, 9.75), and 6 in the honey arm (IQR, 3.5, 7). The same results were obtained in the Kaplan-Meier survival analysis for the median survival time of each arm with the usual care as the reference group. CONCLUSION The symptomatic treatment evaluated has shown to be ineffective against cough.
Collapse
Affiliation(s)
- Carl Llor
- Department of Public Health, General Practice. University of Southern Denmark, Odense, Denmark.,Primary Care Research Institute Jordi Gol (IDIAPJGol), Barcelona, Spain.,CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain.,Via Roma Health Centre, Institut Català de la Salut, Barcelona, Spain
| | - Ana Moragas
- Primary Care Research Institute Jordi Gol (IDIAPJGol), Barcelona, Spain.,CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain.,Jaume I Health Centre, Institut Català de la Salut, Tarragona, Spain.,University Rovira i Virgili, Reus, Spain
| | - Dan Ouchi
- Primary Care Research Institute Jordi Gol (IDIAPJGol), Barcelona, Spain.,Plataforma SCReN, UICEC IDIAPJGol, Barcelona, Spain
| | - Ramon Monfà
- Primary Care Research Institute Jordi Gol (IDIAPJGol), Barcelona, Spain.,Plataforma SCReN, UICEC IDIAPJGol, Barcelona, Spain
| | - Ana Garcia-Sangenís
- Primary Care Research Institute Jordi Gol (IDIAPJGol), Barcelona, Spain.,CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain.,Plataforma SCReN, UICEC IDIAPJGol, Barcelona, Spain
| | - Ainhoa Gómez-Lumbreras
- Primary Care Research Institute Jordi Gol (IDIAPJGol), Barcelona, Spain.,Plataforma SCReN, UICEC IDIAPJGol, Barcelona, Spain
| | - Helena Pera
- Primary Care Research Institute Jordi Gol (IDIAPJGol), Barcelona, Spain.,Plataforma SCReN, UICEC IDIAPJGol, Barcelona, Spain
| | - Jesus Pujol
- Balaguer Health Centre, Institut Català de la Salut, Balaguer, Spain
| | - Rosa Morros
- Primary Care Research Institute Jordi Gol (IDIAPJGol), Barcelona, Spain.,CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain.,Plataforma SCReN, UICEC IDIAPJGol, Barcelona, Spain.,Universitat Autònoma de Barcelona, Bellaterra, Spain
| |
Collapse
|
3
|
Al Naggar Y, Giesy JP, Abdel-Daim MM, Javed Ansari M, Al-Kahtani SN, Yahya G. Fighting against the second wave of COVID-19: Can honeybee products help protect against the pandemic? Saudi J Biol Sci 2021; 28:1519-1527. [PMID: 33519274 PMCID: PMC7832137 DOI: 10.1016/j.sjbs.2020.12.031] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 12/10/2020] [Accepted: 12/16/2020] [Indexed: 12/12/2022] Open
Abstract
Coronavirus Disease (COVID-19) has infected people in 210 nations and has been declared a pandemic on March 12, 2020 by the World Health Organization (WHO). In the absence of effective treatment and/or vaccines for COVID-19, natural products of known therapeutic and antiviral activity could offer an inexpensive, effective option for managing the disease. Benefits of products of honey bees such as honey, propolis, and bee venom, against various types of diseases have been observed. Honey bees products are well known for their nutritional and medicinal values, they have been employed for ages for various therapeutic purposes. In this review, promising effects of various bee products against the emerging pandemic COVID-19 are discussed. Products of honey bees that contain mixtures of potentially active chemicals, possess unique properties that might help to protect, fight, and alleviate symptoms of COVID-19 infection.
Collapse
Affiliation(s)
- Yahya Al Naggar
- Zoology Department, Faculty of Science, Tanta University, 31527 Tanta, Egypt
- General Zoology, Institute for Biology, Martin Luther University Halle-Wittenberg, Hoher weg 8, 06120 Halle (Saale), Germany
| | - John P. Giesy
- Department of Veterinary Biomedical Sciences and Toxicology Centre, University of Saskatchewan, Saskatoon SKS7N 5B3, Canada
| | - Mohamed M. Abdel-Daim
- Department of Zoology, College of Science, King Saud University, P.O. Box 2455, Riyadh 15 11451, Saudi Arabia
- Pharmacology Department, Faculty of Veterinary Medicine, Suez Canal University, Ismailia 41522, Egypt
| | - Mohammad Javed Ansari
- Department of Botany, Hindu College Moradabad (Mahatma Jyotiba Phule Rohilkhand University Bareilly), 244001, India
| | - Saad N. Al-Kahtani
- Arid Land Agriculture Department, College of Agricultural Sciences & Foods, King Faisal University, P.O. Box 400, Al-Ahsa 31982, Saudi Arabia
| | - Galal Yahya
- Microbiology and Immunology Department, Faculty of Pharmacy, Zagazig University, 44519 Al Sharqia, Egypt
- Department of Molecular Genetics, Faculty of Biology, Technical University of Kaiserslautern, Paul-Ehrlich Str. 24, Kaiserslautern 67663, Germany
| |
Collapse
|