Only 1 out of 5 benefits from antibiotics

People who have an acute cough get together at the GP, who then prescribes them almost as much antibiotics. A large-scale study shows that up to one in five patients can benefit from antibiotics. "Nearly half of all airborne infections are of viral origin and antibiotics are not effective against viruses," says Dr. Greet Ieven (UAntwerp).

Acute cough is one of the most common reasons to visit a general practitioner and prescribe antibiotics, drugs that only work against bacteria. For practical reasons, it has not been possible or affordable to perform microbiological studies in all these patients to identify pathogens. That is why science knew little about the exact causes of lower respiratory tract infections in general practice

Research on Viruses and Bacteria

A large-scale European research is changing. Sixteen research networks of general practitioners in thirteen European countries together examined 3,044 adult patients during three consecutive winter periods. In these patients, samples were collected in the same manner on the day of the consultation and four weeks later. All of these samples were collected in the UAntwerp microbiology laboratory and in cooperation with two Dutch laboratories using modern techniques for the detection of all known viruses and bacteria that can cause respiratory tract infections. In addition, resistance to certain antibiotics was also tested on the bacteria found.

In only one in five patients (21%), one of the known classical bacteria has been found to be the cause of respiratory tract infection. Only 5% of all patients were the most important bacterial pathogens, Streptococcus pneumoniae or pneumococcus. This figure was 9% for the 141 patients with pneumonia. The resistance of these pneumococci to penicillin remains very low in all European countries. These results therefore support campaigns to limit the use of antibiotics and guidelines aimed at initially prescribing narrow-spectrum antibiotics if antibiotics are actually needed.

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Lower respiratory infections caused primarily by viruses

Viral cause was found in almost 50% of patients : mainly rhinoviruses, mainly at the origin of colds influenza or influenza viruses and coronaviruses, also major causes of upper respiratory tract infections. "This research shows that the majority of low-level infections detected by the general practitioner are caused by one or more viruses," says Dr. Saluer Ieven (UAntwerp, Institute for Immunization and Infectious Diseases). "Antibiotics are not effective against viruses and therefore should not be prescribed in most cases.Antibiotic therapy is beneficial for at most one in five patients: if antibiotics are needed, it is best to prescribe spectrum antibiotics narrow. "

Dr. Samuel Coenen (UAntwerp, Vaccine and Infectious Diseases Institute) explains: "Although it is difficult to distinguish viral infections from bacterial infections in the daily practice of the general practitioner, previous research on the same patients has already shown that benefits of antibiotic therapy do not outweigh the disadvantages. "

Source: University of Antwerp