Protective effect of antibiotics against serious complications of common respiratory tract infections: retrospective cohort study with the UK General Practice Research Database.
OBJECTIVE
To determine the extent to which antibiotics reduce the risk of serious complications after common respiratory tract infections.


METHODS
Retrospective cohort study.


METHODS
UK primary care practices contributing to the general practice research database.


METHODS
3.36 million episodes of respiratory tract infection.


METHODS
Risk of serious complications in treated and untreated patients in the month after diagnosis: mastoiditis after otitis media, quinsy after sore throat, and pneumonia after upper respiratory tract infection and chest infection. Number of patients needed to treat to prevent one complication.


RESULTS
Serious complications were rare after upper respiratory tract infections, sore throat, and otitis media, and the number needed to treat was over 4000. The risk of pneumonia after chest infection was high, particularly in elderly people, and was substantially reduced by antibiotic use, with a number needed to treat of 39 for those aged > or =65 and 96-119 in younger age groups.


CONCLUSIONS
Antibiotics are not justified to reduce the risk of serious complications for upper respiratory tract infection, sore throat, or otitis media. Antibiotics substantially reduce the risk of pneumonia after chest infection, particularly in elderly people in whom the risk is highest.
Petersen
I
I
UCL Centre for Infectious Disease Epidemiology, Department of Primary Care and Population Sciences, University College London, London NW3 2PQ.
Johnson
A M
AM
Islam
A
A
Duckworth
G
G
Livermore
D M
DM
Hayward
A C
AC
D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005194:Family Practice; D006801:Humans; D007223:Infant; D008875:Middle Aged; D010033:Otitis Media / Q000150:complications / Q000188:drug therapy*; D010612:Pharyngitis / Q000150:complications / Q000188:drug therapy*; D011379:Prognosis; D012141:Respiratory Tract Infections / Q000517:prevention & control*; D012189:Retrospective Studies; D012307:Risk Factors
D000900:Anti-Bacterial Agents