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Lower respiratory tract infection (LRTI)

Victoria Palin, Anna Molter, Miguel Belmonte, Darren M Ashcroft, Andrew White, William Welfare, Tjeerd van Staa

Type
Disease or Syndrome
ID
PH899
Version ID
1877
Data Sources
Valid event data range
01/01/2000 - 30/06/2015
Sex
Female, Male
Agreement Date
2019-04-30
Coding system
Read codes v2
Tags /Collections
ClinicalCodes Repository Phenotype Library

Definition

Objectives:

To examine variations across general practices and factors associated with antibiotic prescribing for common infections in UK primary care to identify potential targets for improvement and optimization of prescribing.

Methods:

Oral antibiotic prescribing for common infections was analysed using anonymized UK primary care electronic health records between 2000 and 2015 using the Clinical Practice Research Datalink (CPRD). The rate of prescribing for each condition was observed over time and mean change points were compared with national guideline updates. Any correlation between the rate of prescribing for each infectious condition was estimated within a practice. Predictors of prescribing were estimated using logistic regression in a matched patient cohort (1:1 by age, sex and calendar time).

Results:

Over 8 million patient records were examined in 587 UK general practices. Practices varied considerably in their propensity to prescribe antibiotics and this variance increased over time. Change points in prescribing did not reflect updates to national guidelines. Prescribing levels within practices were not consistent for different infectious conditions. A history of antibiotic use significantly increased the risk of receiving a subsequent antibiotic (by 22%–48% for patients with three or more antibiotic prescriptions in the past 12months), as did higher BMI, history of smoking and flu vaccinations. Other drivers for receiving an antibiotic varied considerably for each condition.

Conclusions:

Large variability in antibiotic prescribing between practices and within practices was observed. Prescribing guidelines alone do not positively influence a change in prescribing, suggesting more targeted interventions are required to optimize antibiotic prescribing in the UK.

Publications

  • Victoria Palin, Anna Molter, Darren M Ashcroft, Andrew White, William Welfare, Tjeerd van Staa, Antibiotic prescribing for common infections in UK general practice variability and drivers. Journal of Antimicrobial Chemotherapy, 74:2440-2450, 2019.

Clinical Code List

Rows: 46
Code Description Entity type Category Coding System (Read)
H06..00 Acute bronchitis and bronchiolitis res70: LRTI diagnostic Read
H060.00 Acute bronchitis res70: LRTI diagnostic Read
H060.11 Acute wheezy bronchitis res70: LRTI diagnostic Read
H060000 Acute fibrinous bronchitis res70: LRTI diagnostic Read
H060300 Acute purulent bronchitis res70: LRTI diagnostic Read
H060400 Acute croupous bronchitis res70: LRTI diagnostic Read
H060500 Acute tracheobronchitis res70: LRTI diagnostic Read
H060600 Acute pneumococcal bronchitis res70: LRTI diagnostic Read
H060700 Acute streptococcal bronchitis res70: LRTI diagnostic Read
H060800 Acute haemophilus influenzae bronchitis res70: LRTI diagnostic Read
H060A00 Acute bronchitis due to mycoplasma pneumoniae res70: LRTI diagnostic Read
H060x00 Acute bacterial bronchitis unspecified res70: LRTI diagnostic Read
H060z00 Acute bronchitis NOS res70: LRTI diagnostic Read
H061.00 Acute bronchiolitis res70: LRTI diagnostic Read
H061000 Acute capillary bronchiolitis res70: LRTI diagnostic Read
H061200 Acute bronchiolitis with bronchospasm res70: LRTI diagnostic Read
H061300 Acute exudative bronchiolitis res70: LRTI diagnostic Read
H061z00 Acute bronchiolitis NOS res70: LRTI diagnostic Read
H062.00 Acute lower respiratory tract infection res70: LRTI diagnostic Read
H06z.00 Acute bronchitis or bronchiolitis NOS res70: LRTI diagnostic Read
H06z000 Chest infection NOS res70: LRTI diagnostic Read
H06z011 Chest infection res70: LRTI diagnostic Read
H06z100 Lower resp tract infection res70: LRTI diagnostic Read
H06z111 Respiratory tract infection res70: LRTI diagnostic Read
H06z112 Acute lower respiratory tract infection res70: LRTI diagnostic Read
H06z200 Recurrent chest infection res70: LRTI diagnostic Read
H24..11 Chest infection with infectious disease EC res70: LRTI diagnostic Read
H30..00 Bronchitis unspecified res70: LRTI diagnostic Read
H30..11 Chest infection - unspecified bronchitis res70: LRTI diagnostic Read
H30..12 Recurrent wheezy bronchitis res70: LRTI diagnostic Read
H300.00 Tracheobronchitis NOS res70: LRTI diagnostic Read
H301.00 Laryngotracheobronchitis res70: LRTI diagnostic Read
H302.00 Wheezy bronchitis res70: LRTI diagnostic Read
H30z.00 Bronchitis NOS res70: LRTI diagnostic Read
H34..00 Bronchiectasis res70: LRTI diagnostic Read
H340.00 Recurrent bronchiectasis res70: LRTI diagnostic Read
H341.00 Post-infective bronchiectasis res70: LRTI diagnostic Read
H34z.00 Bronchiectasis NOS res70: LRTI diagnostic Read
H50..00 Empyema res70: LRTI diagnostic Read
H500100 Empyema with bronchopleural fistula res70: LRTI diagnostic Read
H501200 Pleural empyema res70: LRTI diagnostic Read
H501400 Purulent pleurisy res70: LRTI diagnostic Read
H51..00 Pleurisy res70: LRTI diagnostic Read
H510300 Acute dry pleurisy res70: LRTI diagnostic Read
H510900 Pneumococcal pleurisy res70: LRTI diagnostic Read
H583200 Eosinophilic bronchitis res70: LRTI diagnostic Read

API

To Export Phenotype Details:

Format API
XML site_root/api/v1/public/phenotypes/PH899/version/1877/detail/?format=xml
JSON site_root/api/v1/public/phenotypes/PH899/version/1877/detail/?format=json
R Package

# Download here

library(ConceptLibraryClient)


# Connect to API

client = connect_to_API(public=TRUE)


# Get details of phenotype

details = get_phenotype_detail_by_version('PH899', '1877', api_client=client)

To Export Phenotype Code List:

Format API
XML site_root/api/v1/public/phenotypes/PH899/version/1877/export/codes/?format=xml
JSON site_root/api/v1/public/phenotypes/PH899/version/1877/export/codes/?format=json
CSV site_root/phenotypes/PH899/version/1877/export/codes/
R Package

# Download here

library(ConceptLibraryClient)


# Connect to API

client = connect_to_API(public=TRUE)


# Get codelists of phenotype

codelists = get_phenotype_code_list('PH899', '1877', api_client=client)

Version History

Version
ID
Name Owner Publish date
1877 Lower respiratory tract infection (LRTI) ieuan.scanlon 2022-04-04 currently shown

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