Incidence, healthcare-seeking behaviours, antibiotic use and natural history of common infection syndromes in England: results from the Bug Watch community cohort study

• Published in: BMC infectious diseases 2021-01, Vol.21 (1), p.105-105, Article 105
• Main Authors: Smith, Catherine M, Shallcross, Laura J, Dutey-Magni, Peter, Conolly, Anne, Fuller, Christopher, Hill, Suzanne, Jhass, Arnoupe, Marcheselli, Franziska, Michie, Susan, Mindell, Jennifer S, Ridd, Matthew J, Tsakos, Georgios, Hayward, Andrew C, Fragaszy, Ellen B
• Format: Article
• Language: English
• Subjects: Anti-Bacterial Agents - therapeutic use; Antibiotic stewardship; Antibiotics; Antimicrobial Stewardship; Care and treatment; Cohort analysis; Cohort Studies; common infections; Communicable diseases; community cohort studies; Delivery of Health Care; Demographic aspects; Diagnosis; Disorders; Dosage and administration; Drug resistance; England - epidemiology; Female; Health behavior; Health care; healthcare-seeking behaviour; Humans; Illnesses; Incidence; Infections; Infections - drug therapy; Infections - epidemiology; Infections - pathology; Infectious diseases; Influenza; Male; Middle Aged; Population; Population studies; Prescriptions; Quality of life; Referral and Consultation - statistics & numerical data; Respiratory tract; Respiratory tract diseases; Soft tissues; Surveys and Questionnaires; Syndrome; Urinary tract; Urogenital system
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-021-05811-7

Better information on the typical course and management of acute common infections in the community could inform antibiotic stewardship campaigns. We aimed to investigate the incidence, management, and natural history of a range of infection syndromes (respiratory, gastrointestinal, mouth/dental, skin/soft tissue, urinary tract, and eye). Bug Watch was an online prospective community cohort study of the general population in England (2018-2019) with weekly symptom reporting for 6 months. We combined symptom reports into infection syndromes, calculated incidence rates, described the proportion leading to healthcare-seeking behaviours and antibiotic use, and estimated duration and severity. The cohort comprised 873 individuals with 23,111 person-weeks follow-up. The mean age was 54 years and 528 (60%) were female. We identified 1422 infection syndromes, comprising 40,590 symptom reports. The incidence of respiratory tract infection syndromes was two per person year; for all other categories it was less than one. 194/1422 (14%) syndromes led to GP (or dentist) consultation and 136/1422 (10%) to antibiotic use. Symptoms usually resolved within a week and the third day was the most severe. Most people reported managing their symptoms without medical consultation. Interventions encouraging safe self-management across a range of acute infection syndromes could decrease pressure on primary healthcare services and support targets for reducing antibiotic prescribing.