Public Healthcare Service Committee, Stockholm County Council, SE-104 25 Stockholm, Sweden; Department of Clinical Science and Education, Södersjukhuset, SE-118 83 Stockholm, Sweden.
Public Health Agency of Sweden, SE-171 82 Solna, Sweden.
Int J Infect Dis. 2022 Nov;124:181-186. doi: 10.1016/j.ijid.2022.09.036. Epub 2022 Oct 6.
The objective of this study was to compare the incidence rate for complications to upper respiratory tract infections (URTIs), including acute bronchitis and lower urinary tract infections (UTIs), for those treated with antibiotics compared to those who were not.
This was a population-based retrospective cohort study in Sweden. Patients diagnosed with otitis, pharyngotonsillitis, sinusitis, acute bronchitis, and lower UTI in primary care between 2014 and 2020 were included. Data on prescribed and dispensed antibiotics and comorbidities for each subject were collected. The outcome we investigated was the number of infectious complications within 30 days and if antibiotic treatment had any effect on risk reduction.
There were 202,995 episodes of otitis, 388,158 pharyngotonsillitis, 125,792 sinusitis, 220,960 bronchitis, and 377,954 lower UTIs in our cohort. No increased risk for complications was seen for untreated compared with treated cases with URTI. For lower UTI, the adjusted odds ratio for febrile UTI or bloodstream infection was 1.53 (95% confidence interval 1.39-1.68).
The risk for infectious complications from common URTIs is low and not modified by antibiotic treatment. On the contrary, patients diagnosed with UTI in whom antibiotics were withheld had an increased 30 days risk for severe infections.
本研究旨在比较上呼吸道感染（URTIs），包括急性支气管炎和下尿路感染（UTIs）患者接受抗生素治疗与未接受抗生素治疗的并发症发生率。
这是一项在瑞典进行的基于人群的回顾性队列研究。纳入 2014 年至 2020 年在初级保健机构诊断为中耳炎、咽炎扁桃体炎、鼻窦炎、急性支气管炎和下尿路感染的患者。收集每位患者的处方和配药抗生素以及合并症数据。我们研究的结果是 30 天内感染并发症的数量，以及抗生素治疗是否对降低风险有影响。
在我们的队列中，有 202995 例中耳炎、388158 例咽炎扁桃体炎、125792 例鼻窦炎、220960 例支气管炎和 377954 例下尿路感染。未接受治疗的 URTI 与接受治疗的 URTI 相比，并发症风险无增加。对于下尿路感染，发热性尿路感染或血流感染的调整比值比为 1.53（95%置信区间 1.39-1.68）。
常见 URTIs 的感染并发症风险较低，抗生素治疗不会改变这一风险。相反，未接受抗生素治疗的 UTI 患者在 30 天内严重感染的风险增加。
