Assessment and management of respiratory tract infections in primary care

Abstract

Background: Respiratory tract infections (RTIs) are common causes of primary care visits and range from benign to life-threatening. Avoiding the overuse of antibiotics, which can lead to antimicrobial resistance, necessitates accurate severity assessment and evidence-based treatment decisions. The correlation between national RTI guidelines and physicians' treatment choices across different countries is not fully understood. Despite efforts to align clinical practice with guidelines, including antimicrobial stewardship programs (ASPs), guideline compliance remains unsatisfactory. Aim: To study the management of common respiratory tract infections in primary care, focusing on severity assessment, guideline compliance, and the impact of antibiotic stewardship programs. Methods: A systematic review and meta-analysis evaluated the role of Fusobacterium necrophorum (FN) in patients with a sore throat, while a randomized controlled trial (RCT) examined the effectiveness of a new ASP in primary care adherence to pharyngotonsillitis guidelines. A cross-sectional survey across five countries assessed the alignment of clinical guidelines with physicians' perceptions of best care. A clinical evaluation measured vital signs in patients with suspected COVID-19 using a camera-based system. Results and Conclusions: The meta-analysis indicates FN is associated with acute sore throat, albeit less than GAS. The RCT found that the ASP did not alter guideline compliance. The survey revealed national variations in guidelines and physician adherence to them. The clinical investigation demonstrated the camera-based system's potential, while accuracy and reliability requirements necessitate further refinement and validation for clinical use.