scholarly journals Predisposing factors to acquisition of acute respiratory tract infections in the community: a systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ashley Hammond ◽  
Alice Halliday ◽  
Hannah V. Thornton ◽  
Alastair D. Hay
Keyword(s):  
Risk Factors ◽  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Smoking Status ◽  
Predisposing Factors ◽  
Vulnerable Groups ◽  
Antibiotic Prescribing ◽  
Related Factors ◽  
Factors Associated ◽  
Tract Infections

Abstract Background Preventing respiratory tract infections (RTIs) could have profound effects on quality of life, primary care workload, antibiotic prescribing and stewardship. We aimed to identify factors that increase and decrease RTI acquisition within Organisation for Economic Cooperation and Development (OECD) member countries. Methods Systematic search of Medline, Embase, Cochrane and ISI Web of Knowledge for studies conducted up to July 2020 reporting predisposing factors for community RTI acquisition. Pooled odds ratios were calculated using a random-effects model. Results 23 studies investigated risk factors associated with community-acquired pneumonia (n = 15); any RTI (n = 4); influenza like illness (n = 2); and lower RTI (n = 2). Demographic, lifestyle and social factors were: underweight BMI (pooled odds ratio (ORp 2.14, 95% CI 1.58 to 2.70, p = 0.97); male sex (ORp 1.30, 95% CI 1.27 to 1.33, p = 0.66); contact with pets (ORp 1.35, 95% CI 1.16 to 1.54, p = 0.72); contact with children (ORp 1.35, 95% CI 1.15 to 1.56, p = 0.05); and ex-smoking status (ORp 1.57, 95% CI 1.26 to 1.88, p = 0.76). Health-related factors were: chronic liver condition (ORp 1.30, 95% CI 1.09 to 1.50, p = 0.34); chronic renal condition (ORp 1.47, 95% CI 1.09 to 1.85, p = 0.14); and any hospitalisation in previous five years (ORp 1.64, 95% CI 1.46 to 1.82, p = 0.66). Conclusions We identified several modifiable risk factors associated with increased likelihood of acquiring RTIs in the community, including low BMI, contact with children and pets. Modification of risk factors and increased awareness of vulnerable groups could reduce morbidity, mortality and antibiotic use associated with RTIs. PROSPERO registration CRD42019134176.

scholarly journals Systematic Review of Factors Associated with Antibiotic Prescribing for Respiratory Tract Infections

2016 ◽  
Vol 60 (7) ◽  
pp. 4106-4118 ◽  
Author(s):  
Rachel McKay ◽  
Allison Mah ◽  
Michael R. Law ◽  
Kimberlyn McGrail ◽  
David M. Patrick
Keyword(s):  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Multivariable Analysis ◽  
Signs And Symptoms ◽  
Antibiotic Use ◽  
Antibiotic Prescribing ◽  
Upper Respiratory Tract ◽  
Medical Subject Headings ◽  
Factors Associated ◽  
Tract Infections

ABSTRACTAntibiotic use is a modifiable driver of antibiotic resistance. In many circumstances, antibiotic use is overly broad or unnecessary. We systematically assessed factors associated with antibiotic prescribing for respiratory tract infections (RTI). Studies were included if they used actual (not self-reported or intended) prescribing data, assessed factors associated with antibiotic prescribing for RTIs, and performed multivariable analysis of associations. We searched Medline, Embase, and International Pharmaceutical Abstracts using keyword and MeSH (medical subject headings) search terms. Two authors reviewed each abstract and independently appraised all included texts. Data on factors affecting antibiotic prescribing were extracted. Our searches retrieved a total of 2,848 abstracts, with 97 included in full-text review and 28 meeting full inclusion criteria. Compared to other factors, diagnosis of acute bronchitis was associated with increased antibiotic prescribing (range of adjusted odds ratios [aOR], 1.56 to 15.9). Features on physical exam, such as fever, purulent sputum, abnormal respiratory exam, and tonsillar exudate, were also associated with higher odds of antibiotic prescribing. Patient desire for an antibiotic was not associated or was modestly associated with prescription (range of aORs, 0.61 to 9.87), in contrast to physician perception of patient desire for antibiotics, which showed a stronger association (range of aORs, 2.11 to 23.3). Physician's perception of patient desire for antibiotics was strongly associated with antibiotic prescribing. Antimicrobial stewardship programs should continue to expand in the outpatient setting and should emphasize clear and direct communication between patients and physicians, as well as signs and symptoms that do and do not predict bacterial etiology of upper respiratory tract infections.

scholarly journals The risk for respiratory tract infections and antibiotic in a general population and among asthmatics

2021 ◽  
pp. 00429-2021
Author(s):  
Marta A. Kisiel ◽  
Xingwu Zhou ◽  
Eythor Björnsson ◽  
Mathias Holm ◽  
Anna Dahlman-Höglund ◽  
...  
Keyword(s):  
General Population ◽  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Respiratory Infections ◽  
Smoking Status ◽  
Female Gender ◽  
Antibiotic Use ◽  
Factors Associated ◽  
Antibiotics Use ◽  
Tract Infections

AimThe aim of this study was to investigate occupational, environmental, early life, and other risk factors associated with respiratory infections and antibiotics use, in a general population and among asthmatics.MethodThis study included 15 842 participants of the RHINE study aged 25–54 years from five Nordic countries, who answered a questionnaire covering respiratory outcomes, exposures, demographic characteristics and numbers of infections and courses of antibiotics the last 12 months. Multiple logistic regression with and without adjustment for age, gender, smoking status, BMI and center were used to study the risk of infection and antibiotics in relation to asthma, and also the association between infection and antibiotics and occupations.ResultsIn the whole population, 11.6% reported having three or more respiratory infections, and 14.7% had used antibiotics because of respiratory tract infections within the last year. Asthmatics reported a tripled odd for such infections (adjusted OR (95% CI) 2.98 (2.53–3.52) and antibiotics use (adjusted OR 3.67 (3.18–4.24) as compared to non-asthmatics. Both in the general and the asthmatic population, female gender, obesity and exposure to building dampness were associated with respiratory infections. Female gender, and current smoking and living in Tartu were associated with antibiotic use. The use of antibiotics was doubled in people hospitalised for severe respiratory infection in childhood.ConclusionIn this study we identified several factors associated with increased respiratory infections and use of antibiotics in a general population and among asthmatics. The frequency of respiratory infections and subsequent antibiotic treatment were increased among asthmatics.

scholarly journals Early Life Factors Associated with Preschool Wheezing in Preterm Infants

Children ◽  
2021 ◽  
Vol 8 (9) ◽  
pp. 732
Author(s):  
Ying-Lun Hsu ◽  
Hsin-Chun Huang ◽  
Ting-Yu Su ◽  
I-Lun Chen
Keyword(s):  
Risk Factors ◽  
Allergic Rhinitis ◽  
Logistic Regression ◽  
Respiratory Tract ◽  
Preterm Infants ◽  
Early Life ◽  
Respiratory Tract Infections ◽  
Factors Associated ◽  
Early Life Factors ◽  
Tract Infections

Advanced neonatal care has increased the survival of neonates born prematurely, and prematurity is a well-known risk factor for asthma/wheezing disorders. Thus, this prospective study aimed to determine the early life factors associated with preschool wheezing in premature neonates. Preterm neonates born between 2012 and 2017 were recruited, excluding those with bacterial infection within 7 days of life, maternal sepsis, and maternal chorioamnionitis. Birth and admission history, comorbidities, and maternal history were documented. Respiratory problems were followed-up at the neonatal outpatient department. Patients were divided into wheezing and non-wheezing groups. Data were analyzed using the Mann–Whitney test and Fisher’s exact test, and multivariable logistic regression was used to define the risk factors of preschool wheezing/asthma. A total of 125 preterm infants were enrolled, including 19 in the wheezing group and 106 in the non-wheezing group. Patients in the wheezing group had longer duration of intubation (p = 0.025), higher rates for exclusive breast milk feeding (p = 0.012), and higher re-hospitalization rates for respiratory tract infections (p < 0.001), especially for respiratory syncytial virus (RSV) bronchiolitis (p = 0.045). The incidence of allergic rhinitis was also higher in the wheezing group (p = 0.005). After multivariable logistic regression, allergic rhinitis and re-hospitalization for respiratory tract infections were two significant risk factors for preschool wheezing/asthma in premature neonates. Close follow-up of premature infants at high risk for asthma susceptibility is recommended.

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