Acute Bronchitis, Acute Exacerbation Chronic Obstructive Pulmonary Disease, Community Acquired Pneumonia (CAP), Influenza, Lower Respiratory Tract Infections
Conditions
Keywords
Primary Care, Antimicrobial Stewardship, Electronic Health Records
Brief summary
Primary aim: To describe participant characteristics at the time of the index lower respiratory tract infection (LRTI) episode in adults managed in primary care in France, using anonymized electronic health records from routine clinical practice between January 2015 and December 2024. Secondary aims: To describe and quantify patterns of antibiotic prescribing (rate, type, and duration of treatment) and short-term outcomes, including LRTI-related reconsultations and severe complications within 30 days after the index consultation. The overall objective is to better characterize real-world management and outcomes of lower respiratory tract infections in primary care and to identify potential areas for improving quality of care and optimizing antibiotic stewardship.
Detailed description
Lower respiratory tract infections are a frequent reason for consultation and antibiotic prescribing in primary care. However, nationally representative data describing real-world management in routine practice remain limited in France. This nationwide retrospective observational study uses anonymized electronic health records from the THIN® France database, a large primary care data warehouse collecting routinely recorded clinical data from general practitioners. The study includes adults aged 18 years and older with a recorded episode of community-acquired lower respiratory tract infection between January 2015 and December 2024. Each participant contributes a single index episode and is followed for 30 days to assess short-term outcomes. The study period allows the evaluation of management practices over a 10-year timeframe in routine ambulatory care. The main objective is to describe patients characteristics and real-world management of lower respiratory tract infections in primary care, with a focus on patterns of care, treatment strategies, and short-term outcomes. This study is based exclusively on previously collected anonymized data and does not involve any intervention or change in patient care. By providing a large-scale overview of routine practice, the study aims to improve understanding of current management approaches and identify potential areas for optimizing antibiotic use in primary care.
Interventions
None listed
Sponsors
Hôpital Raymond Poincaré
Versailles Saint-Quentin-en-Yvelines University
University of Lausanne Hospitals
Clinityx by Gers Data
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age ≥18 years * Recorded diagnosis of community-acquired lower respiratory tract infection in primary care between Jan 1, 2015 and Dec 31, 2024 * At least 12 months of medical history available before the index consultation
Exclusion criteria
* Age \<18 years * Less than 12 months of medical data before index date
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Participant Characteristics at Index LRTI Episode | Index consultation | Descriptive summary of participant characteristics at the index lower respiratory tract infection episode, including age, sex, body mass index, smoking status, alcohol use, comorbidities, and vaccination status, overall and by antibiotic exposure group. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| 30-Day LRTI-Related Reconsultation Rate | 30 days | Proportion of participants with a follow-up consultation related to LRTI within 30 days. |
| 30-Day Severe Complication Rate After LRTI | 30 days | Occurrence of Sepsis/septic shock, Pleural effusion, Lung abscess, Acute respiratory distress syndrome (ARDS) within 30 days after the index episode. |
| Type of Antibiotics Prescribed for Antibiotic-treated LRTIs | Index consultation | Distribution of antibiotic classes prescribed at the index episode. |
| Duration of Antibiotic Treatment for Antiobiotic-treated LRTIs | Index consultation | Duration of antibiotic treatment prescribed for the index episode. |
| Antibiotic Prescribing Rate | Index consultation | Proportion of participants with an antibiotic prescription at the index episode, stratified on LRTI type |
Outcome results
None listed