Sunday, July 13, 2008
Bacterial superinfection in upper respiratory tract infections estimated by increases in CRP values: A diagnostic follow-up in primary care.
Scand J Prim Health Care. 2008 Jul
Lingard H, Zehetmayer S, Maier M.
Department of General Practice and Family Medicine, Medical University Vienna, Vienna, Austria.
Objective.
The aim of this study was to estimate the rate of bacterial superinfection in patients with URTI by using on-site determination of C-reactive protein (CRP). Design. A prospective cohort study.
Setting.
A total of 30 primary care practices. Subjects. Patients with URTI. Intervention. The CRP value was determined at the first consultation and at a follow-up within 3-5 days. CRP values of 30 units (mg) or higher were considered to be an indication of bacterial involvement. Main outcome measures. CRP values during follow-up and duration of illness.
Results.
Among the 506 patients included, 73.1% exhibited a CRP value below the defined limit at their first visit and were considered to suffer from URTI of viral origin. The rate of subsequent bacterial superinfection was 8.1%. Compared with patients suffering from URTI of bacterial or viral origin the duration of illness in patients with bacterial superinfection was significantly longer.
Conclusion.
During follow-up of patients with URTI, the prevalence of bacterial superinfection detected by using a near patient CRP determination is surprisingly low. This result should help to reduce the prescription rate of antibiotics in primary care.
InformaWorldLabels: bacterial superinfection; respiratory tract; URTI; CRP; family practice; primary care
