Dansk Selskab for Almen Medicin logoDansk Selskab for Almen Medicin logo
Klinisk vejledning

Publiseret: 2024

Akutte luftvejsinfektioner

og rationel antibiotikabehandling i almen praksis

Referencer

Referencer for antibiotikaforbruget i almen praksis

  1. Danmarks Tekniske Universitet og Statens Serum Institut. DANMAP 2022: Use of antimicrobial agents and occurrence of antimicrobial resistance in bacteria from food animals, food and humans in Denmark. ISSN 1600-2032. Tilgængelig via: https://www.danmap.org/reports/2022.

  2. Aabenhus R, Hansen MP, Siersma V, et al. Clinical indications for antibiotic use in Danish general practice: results from a nationwide electronic prescription database. Scand J Prim Health Care 2017;35(2):162-69.

  3. Sundhedsstyrelsen. Vejledning om ordination af antibiotika. Version 1.1. 2012. Tilgængelig via: https://www.sst.dk/da/Fagperson/Ansvarlig-medicinering/Rationel-farmakoterapi/Vejledninger-paa-laegemiddelomraadet/Vejledning-om-ordination-af-antibiotika.

  4. National handleplan for antibiotika til mennesker. 2017. Sundheds- og Ældreministeriet. Tilgængelig via: https://sum.dk/publikationer-sundhed/2017/juli/national-handlingsplan-for-antibiotika-til-mennesker.

  5. European Centre for Disease Prevention and Control. Antimicrobial consumption in the EU/EEA (ESAC-Net) – Annual Epidemiological Report 2021. Stockholm: ECDC; 2022. Tilgængelig via: https://www.ecdc.europa.eu/en/publications-data/surveillance-antimicrobial-consumption-europe-2021.

  6. Rådet for Anvendelse af Dyr Sygehusmedicin: Baggrundsnotat for hensigtsmæssig anvendelse af antibiotika ved nedre luftvejsinfektioner i almen praksis og på hospital. 2016. Tilgængelig via: https://rads.dk/media/3996/bgn-antibiotika-nedre-luftvejsinf-vers-1-0-november-2016-267967.pdf.

  7. Principi N, Autore G, Argentiero A, et al. Short-term antibiotic therapy for the most common bacterial respiratory infections in infants and children. Front. Pharmacol. 14:1174146.

  8. Spellberg B, Rice LB. Duration of Antibiotic Therapy: Shorter Is Better. Ann Intern Med. 2019;171(3):210-211.

  9. Ståhlgren GS, Tyrstrup M, Edlund C, et al. Penicillin V four times daily for five days versus three times daily for 10 days in patients with pharyngotonsillitis caused by group A streptococci: randomised controlled, open label, non-inferiority study. BMJ 2019; 367:I5337

  10. Dinh A, Ropers J, Duran C, et al. Discontinuing β-lactam treatment after 3 days for patients with community-acquired pneumonia in non-critical care wards (PTC): a double-blind, randomised, placebo-controlled, non-inferiority trial. Lancet 2021; 397(10280):1195-1203.

  11. Costelloe C, Metcalfe C, Lovering A, et al. Effect of antibiotic prescribing in primary care on antimicrobial resistance in individual patients: systematic review and meta-analysis. BMJ 2010; 340:c2096.

  12. World Health Organization (WHO). Antibiotic resistance. Opdateret: 31. juli 2020. Tilgængelig via: https://www.who.int/news-room/fact-sheets/detail/antibiotic-resistance.

  13. O’Neill J. Tackling drug-resistant infections globally: Final report and recommendations. The review of antimicrobial resistance, 2016. Tilgængelig via: https://amr-review.org/sites/default/files/160518_Final%20paper_with%20cover.pdf.

Referencer for håndtering af akutte luftvejsinfektioner

  1. Physiology of aging. In Cassel, Leipzig, Cohen et al. (eds). Geriatric Medicine: an evidence-based approach. 9th ed. New York, Springer Press, 2009.

  2. Bekendtgørelse om autoriserede sundhedspersoners benyttelse af medhjælp (delegation af forbeholdt sundhedsfaglig virksomhed). BEK nr. 1219 af 11/12/2009. Tilgængelig via: https://www.retsinformation.dk/eli/lta/2009/1219.

  3. Friedemann CS, Lunn H, Wing G, et al. Optimising GPs’ communication of advice to facilitate patients’ self-care and promt follow-up when the diagnosis is uncertain: a realist review of ‘safety-netting’ in primary care. BMJ Qual Saf 2022;31:541-554.

  4. Coxeter PD, Mar CD, Hoffmann TC. Parents’ Expectations and Experiences of Antibiotics for Acute Respiratory Infections in Primary Care. Ann Fam Med 2017;15(2):149-54.

Referencer for akut otitis media

  1. Alho OP, Koivu M, Sorri M, et al. The occurrence of acute otitis media in infants. A life-table analysis. Int J Pediatr Otorhinolaryngol 1991; 21(1):7-14.

  2. Jamal A, Alsabea A, Tarakmeh M, et al. Etiology, diagnosis, complications, and management of acute otitis media in children. Cureus 2022; 14(8):e28019.

  3. Heikkinen T, Chonmaitree T. Importance of respiratory viruses in acute otitis media. Clin Microbiol Rev 2003; 16(2):230-241.

  4. Rovers MM, Schilder AGM, Zielhuis GA, et al. Otitis media. Lancet 2004; 365:465-473.

  5. Coker TR, Chan LS, Newberry SL, et al. Diagnosis, microbial epidemiology, and antibiotic treatment of acute otitis media in children. A systematic review. JAMA 2010; 304(19):2161-2169.

  6. Lous J. Tympanometri, hvordan? En opdatering. Hvad er tympanometri? Månedsskrift for almen praksis 2013 (marts):238-245. Tilgængelig via: https://www.maanedsskriftet.dk/files/pdf/10568.pdf.

  7. Karma PH, Penttila MA, Sipila MM, et al. Otoscopic diagnosis of middle ear effusion in acute and non-acute otitis media. I. The value of different otoscopic findings. Int J Pediatr Otorhinolaryngol 1989;17(1):37-49.

  8. Saeed K, Coglianese CL, McCormick DP, et al. Otoscopic and tympanometric findings in acute otitis media yielding dry tap at tympanocentesis. Pediatr Infect Dis J 2004;23(11):1030-1034.

  9. Sundhedsstyrelsen 2015. National klinisk retningslinje for behandling med trommehindedræn. Diagnostik af mellemørebetændelse og indikationer for trommehindedræn mv. blandt børn i aldersgruppen 0-5 år. Tilgængelig via: https://www.sst.dk/da/udgivelser/2015/~/media/B23EC346DEC1408C8419725D96A76C0A.ashx.

  10. Lildholdt T, Felding JU, Eriksen EW, et al. Diagnosis and treatment of ear diseases in general practice. A controlled trial of the effect of the introduction of middle ear measurement (tympanometry). Ugeskr Laeger 1991;153(43):3004-3007.

  11. Johansen EC, Lildholdt T, Damsbo N, et al. Tympanometry for diagnosis and treatment of otitis media in general practice. Fam Pract 2000;17(4):317- 322.

  12. Heslop A, Lildholdt T, Gammelgaard N, et al. Topical ciprofloxacin is superior to topical saline and systemic antibiotics in the treatment of tympanostomy tube otorrhea in children: The results of a randomized clinical trial. Laryngoscope 2010; 120(12):2516-2520.

  13. van Dongen TM, van der Heijden GJ, Venekamp RP, et al. A trial of treatment for acute otorrhea in children with tympanostomy tubes. N Engl J Med 2014; 370(8):723-733.

  14. Dohar J, Giles W, Roland P, et al. Topical ciprofloxacine/dexamethasone superior to oral amoxicillin/clavulanic acid in acute otitis media with otorrhea through tympanostomy tubes. Pediatrics 2006; 118(3):e561-9.

  15. Venekamp RP, Sanders SL, Glasziou PP, et al. Antibiotics for acute otitis media in children. Cochrane Database Syst Rev 2023;11:CD000219.

  16. Petersen I, Johnson AM, Islam A, et al. Protective effect of antibiotics against serious complications of common respiratory tract infections: retrospective cohort study with the UK General Practice Research Database. BMJ 2007; 335(7627):982.

  17. Dowell SF, Marcy SM, Philips WR, el al. Otitis media – principles of judicious use of antimicrobial agents. Pediatrics 1998; 101:165-171.

Referencer for akut faryngo-tonsillitis

  1. McIsaac WJ, White D, Tannenbaum D, et al. A clinical score to reduce unnecessary antibiotic use in patients with sore throat. CMAJ 1998;158(1):75-83.

  2. Fine AM, Nizet V, Mandl KD. Large-scale validation of the Centor and McIsaac scores to predict group A streptococcal pharyngitis. Arch Intern Med 2012;172(11):847-852.

  3. Cohen JF, Bertille N, Cohen R, et al. Rapid antigen detection test for group A streptococcus in children with pharyngitis. Cochrane Database Syst Rev 2016;(7):1-312.

  4. Marchello C, Ebell MH. Prevalence of group C Streptococcus and Fusobacterium Necrophorum in patients with sore throat: A meta-analysis. Ann Fam Med 2016;14(6):567-574.

  5. Gunnarsson RK, Manchal N. Group C beta hemolytic Streptococci as a potential pathogen in patients presenting with an uncomplicated acute sore throat – a systematic literature review and meta-analysis. Scand J Prim Health Care 2020;38(2):226-237.

  6. Malmberg S, Petrén S, Gunnarsson R, et al. Acute sore throat and Fusobacterium necrophorum in primary healthcare: a systematic review and meta-analysis. BMJ Open 2021;11(9):1-9.

  7. Klug TE, Rusan M, Fuursted K, et al. A systematic review of Fusobacterium necrophorum-positive acute tonsillitis: prevalence, methods of detection, patient characteristics, and the usefulness of the Centor score. Eur J Clin Microbiol Infect Dis 2016; 35(12):1903–1912.

  8. Little P, Moore M, Hobbs FD, et al. PRImary care Streptococcal Management (PRISM) study: identifying clinical variables associated with Lancefield group A β-haemolytic streptococci and Lancefield non-Group A streptococcal throat infections from two cohorts of patients presenting with an acute sore throat. BMJ Open 2013;3(10):1-7.

  9. Cohen JF, Pauchard JY, Hjelm N, et al. Efficacy and safety of rapid tests to guide antibiotic prescriptions for sore throat. Cochrane Database Syst Rev 2020;(6):1-47.

  10. Willis BH, Coomar D, Baragilly M. Comparison of Centor and McIsaac scores in primary care: A meta-analysis over multiple thresholds. Br J Gen Pract 2020;70(693):e245-e254.

  11. Centor RM, Witherspoon JM, Dalton HP, et al. The diagnosis of strep throatin adults in the emergency room. Med Decis Making 1981;1(3):239-246.

  12. Lean WL, Arnup S, Danchin M, et al. Rapid diagnostic tests for group a streptococcal pharyngitis: A meta-analysis. Pediatrics 2014;134(4):771-781.

  13. Statens Serum Institut. Risikovurdering Gruppe A streptokokker i Danmark, 2023. Tilgængelig via: https://www.ssi.dk/-/media/arkiv/dk/sygdomme-beredskab-og-forskning/sygdomsovervaagning/risikovurderinger/risikovurdering-invasiv-gas-20012023.pdf.

  14. Gunnarsson RK, Holm SE, Söderström M. The prevalence of beta-haemolytic streptococci in throat specimens from healthy children and adults: Implications for the clinical value of throat cultures. Scand J Prim Health Care 1997;15(3):149-155.

  15. Del Mar CB, Glasziou PP, Spinks AB. Antibiotics for sore throat. Cochrane Database Syst Rev 2006;(4):1-56.

  16. Spinks A, Glasziou PP, Del Mar CB. Antibiotics for sore throat. Cochrane Database Syst Rev 2013;(11):1-59.

  17. Spinks A, Glasziou PP, Del Mar CB. Antibiotics for treatment of sore throat in children and adults. Cochrane Database Syst Rev 2021;(12):1-77.

  18. Klug TE, Rusan M, Fuursted K, et al. Fusobacterium necrophorum: Most prevalent pathogen in peritonsillar abscess in Denmark. Clin Infect Dis 2009;49(10):1467-72.

  19. Hagelskjaer KL, Prag J. Lemierre’s syndrome and other disseminated Fusobacterium necrophorum infections in Denmark: a prospective epidemiological and clinical survey. Eur J Clin Microbiol Infect Dis 2008;27(9):779-789.

  20. Cooper RJ, Hoffman JR, Bartlett JG, et al. Principles of appropriate antibiotic use for acute pharyngitis in adults: background. Ann Emerg Med 2001;37(6):711-719.

Referencer for akut rhinosinuit

  1. Ah-See KW, Evans AS. Sinusitis and its management. BMJ 2007; 334(7589):358-361.

  2. Hansen JG. Akut rhinosinusitis (ARS) – diagnostik og behandling af voksne i almen praksis. Doktorafhandling. Health. Aarhus Universitet; 2013. Tilgængelig via: https://kea.au.dk/fileadmin/KEA/filer/PhD_theses/Jens_Georg_DMSc_thesis.pdf.

  3. Fokkens WJ, Lund VJ, Hopkins C, et al. European Position Paper on Rhinosinusitis and Nasal Polyps 2020 Rhinology 2020 Suppl. 29: 1-46.

  4. Hansen JG, Lund E. The association between paranasal computerized tomography scans and symptoms and signs in a general practice population with acute maxillary sinusitis. APMIS 2011; 119(1):44-48.

  5. Ebell MH, McKay B, Dale A, et al. Accuracy of signs and symptoms for the diagnosis of acute rhinosinusitis and acute bacterial rhinosinusitis. Ann Fam Med 2019; 17(2):164-172.

  6. Takeda T, Hoogland J, Hansen JG, et al. Diagnostic prediction models for CT-confirmed and bacterial rhinosinusitis in primary care: individual participant data meta-analysis. Br J Gen Pract 2022; 72(721):e601-e608.

  7. Hansen JG, Schmidt H, Rosborg J, et al. Predicting acute maxillary sinusitis in a general practice population. BMJ 1995; 311(6999): 233-236.

  8. Ling D, Mitchell B, Williams CP, et al. Saline nasal irrigation for acute upper respiratory tract infections. Cochrane Database Syst Rev 2015; 4:CD006821.

  9. Hox V, Lourijsen E, Jordens A, et al. Benefits and harms of systemic steroids for short- and long-term use in rhinitis and rhinosinusitis: an EAACI position paper. Clin Transl Allergy 2020; 10(38).

  10. Zalmanovici Trestioreanu A, Yaphe J. Intranasal steroids for acute sinusitis. Cochrane Database Syst Rev 2013; 12:CD005149.

  11. Sinusitis (acute): antimicrobial prescribing. Nasal corticosteroids. NICE guideline; 2017. Tilgængelig via: https://www.nice.org.uk/guidance/ng79/chapter/summary-of-the-evidence#nasal-corticosteroids.

  12. Lemiengre MB, van Driel ML, Merenstein D, et al. Antibiotics for acute rhinosinusitis in adults. Cochrane Database Syst Rev 2018; 9:CD006089.

  13. Hansen FS, Hoffmanns R, Georgalas C, et al. Complications of acute rhinosinusitis in The Netherlands. Fam Pract 2012; 29(2):147-153.

  14. Barbar-Craig H, Gupta Y, Lund VJ, et al. British Rhinological Society audit of the role of antibiotics in complications of acute rhinosinusitis: a national prospective audit. Rhinology 2010; 48:344-347.

Referencer for akutte nedre luftvejsinfektioner

  1. Cough (acute): antimicrobial prescribing. Acute cough associated with acute bronchitis. NICE guideline; 2019 Tilgængelig via: https://www.nice.org.uk/guidance/ng120/chapter/Recommendations#managing-acute-cough.

  2. Gardiner SJ, Gavranich JB, Chang AB. Antibiotics for community-acquired lower respiratory tract infections secondary to Mycoplasma pneumoniae in children. Cochrane Database Syst Rev 2015 Jan 8;1(1): CD004875.

  3. Holm A, Nexoe J, Bistrup LA, Pedersen SS, Obel N, Nielsen LP, Pedersen C. Aetiology and prediction of pneumonia in lower respiratory tract infection in primary care. Br J Gen Pract. 2007 Jul;57(540):547-54.

  4. Ebell MH. Predicting pneumonia in adults with respiratory illness. Am Fam Physician 2007; Aug 15;76(4):560-2.

  5. Schot MJC, Dekker ARJ, Giorgi WG, et al. Diagnostic value of signs, symptoms and diagnostic tests for diagnosing pneumonia in ambulant children in developed countries: a systematic review; NPJ Prim Care Resp Med 2018; Oct 26; 28(1):40.

  6. Metlay JP, Kapoor WN, Fine MJ, et al. Does this patient have community-acquired pneumonia? Diagnosing pneumonia by history and physical examination. JAMA 1997; Nov 5;278(17):1440-5.

  7. Hopstaken RM, Muris JW, Knottnerus JA, et al. Contributions of symptoms, signs, erythrocyte sedimentation rate, and C-reactive protein to a diagnosis of pneumonia in acute lower respiratory tract infection. Br J Gen Pract 2003; 53:358-64

  8. Grief SN, Loza JK. Guidelines for the Evaluation and Treatment of Pneumonia. Prim Care 2018 Sep;45(3):485-503

  9. Clark JE., Hammal D, Spencer D, et al. Children with pneumonia: how do they present and how are they managed? Arch Dis Child 2007; 92(5):394-98.

  10. Retningslinjer for håndtering af voksne patienter indlagt med pneumoni. Dansk Lungemedicinsk Selskab og Dansk Selskab for Infektionsmedicin. 2021. Tilgængelig via: https://lungemedicin.dk/wp-content/uploads/2021/05/DLS_DSI_Pneumoni_2021.pdf.

  11. Bont J, Hak E, Hoes AW, et al. A prediction rule for elderly primary-care patients with lower respiratory tract infections. Eur Respir J 2007; May;29(5):969-75.

  12. McNally M, Curtain J, O’Brien KK, et al. Validity of British Thoracic Society guidance (the CRB-65 rule) for predicting the severity of pneumonia in general practice: systematic review and meta-analysis. Br J Gen Pract. 2010; Oct;60(579):e423-33.

  13. Agergaard P, Dahl K, Hartling U, et al. Pneumoni hos børn – diagnostik og behandling. Dansk Pædiatrisk Selskab 2018; Tilgængelig via: https://www.paediatri.dk/images/dokumenter/vejledninger_2018/Pneumoni_hos_boern_diagnostik_og_behandling_.pdf.

  14. Smith SM, Fahey T, Smucny J, et al. Antibiotics for acute bronchitis. Cochrane Database Syst Rev 2017; (4):CD000245.

  15. Becker LA, Hom J, Villasis-Keever M, et al. Beta2-agonists for acute cough or a clinical diagnosis of acute bronchitis. Cochrane Database Syst Rev 2015; Sep 3; (9): CD001726.

  16. Little P, Stuart B, Moore M, et al. Amoxicillin for acute lower-respiratory-tract infection in primary care when pneumonia is not suspected: a 12-country, randomised, placebo-controlled trial. Lancet Infect Dis 2013; Feb;13(2):123-9.

  17. Llor C, Moragas A, Bayona C, et al. Efficacy of anti-inflammatory or antibiotic treatment in patients with non-complicated acute bronchitis and discoloured sputum: randomised placebo controlled trial. BMJ 2013; 347:f5762.

  18. Melbye H, Joensen L, Risor MB, et al. Symptoms of respiratory tract infection and associated care-seeking in subjects with and without obstructive lung disease; the Tromso Study: Tromso 6. BMC Pulm Med 2012; Sep 7:12:51.

  19. Meropol SB, Localio AR, Metlay JP. Risks and benefits associated with antibiotic use for acute respiratory infections: a cohort study. Ann Fam Med. 2013; Mar-Apr;11(2):165-72.

  20. Metlay JP, Atlas SJ, Borowsky LH, et al. Time course of symptom resolution in patients with community-acquired pneumonia. Respir Med 1998; Sep;92(9):1137-42.

Referencer for C-reaktivt protein

  1. Pepys MB, Hirschfield GM. C-reactive protein: a critical update. J Clin Invest 2003; 111(12):1805-1812.

  2. Tillet WS, Francis T. Serological reactions in pneumonia with a non-protein somatic fraction of pneumococcus. J Exp Med 1930; Sep 30; 52(4): 561–571.

  3. Boere TM, van Buul LW, Hopstaken RM, et al. Effect of C reactive protein point-of-care testing on antibiotic prescribing for lower respiratory tract infections in nursing home residents: cluster randomised controlled trial. BMJ 2021; Sep 21; 374:n2198.

  4. Smedemark SA, Aabenhus R, Llor C, et al. Biomarkers as point-of-care tests to guide prescription of antibiotics in people with acute respiratory infections in primary care. Cochrane Database Syst Rev 2022; Oct 17; 10(10): CD010130.

  5. Falk G, Fahey T. C-reactive protein and community-acquired pneumonia in ambulatory care: systematic review of diagnostic accuracy studies. Fam Pract 2009; 26(1):10-21.

  6. Holm A, Pedersen SS, Nexoe J, et al. Procalcitonin versus C-reactive protein for predicting pneumonia in adults with lower respiratory tract infection in primary care. Br J Gen Pract 2007; 57(540):555-560.

  7. Cals JWL, Schot MJC, de Jong SAM, et al. Point-of-Care C-Reactive Protein Testing and Antibiotic Prescribing for Respiratory Tract Infections: A Randomized Controlled Trial. Ann Fam Med 2010; 8(2):124-133.

  8. Cals JWL, Butler CC, Hopstaken RM, et al. Effect of point of care testing for C reactive protein and training in communication skills on antibiotic use in lower respiratory tract infections: cluster randomised trial. BMJ 2009; 338:B1374.

  9. van Hecke O, Bjerrum L, Gentile I, et al. Guidance on C-reactive protein point-of-care testing and complementary strategies to improve antibiotic prescribing for adults with lower respiratory tract infections in primary care. Front Med (Lausanne) 2023 30:10:1166742.

  10. Staiano A, Bjerrum L, Llor C, et al. C-reactive protein point-of-care testing and complementary strategies to improve antibiotic stewardship in children with acute respiratory infections in primary care. Front Pediatr. 2023 11:1221007.