PT - JOURNAL ARTICLE AU - Hilda Hounkpatin AU - Beth Stuart AU - Shihua Zhu AU - Guiqing Yao AU - Michael Moore AU - Christin Löffler AU - Paul Little AU - Timothy Kenealy AU - David Gillespie AU - Nick A Francis AU - Jennifer Bostock AU - Taeko Becque AU - Bruce Arroll AU - Attila Altiner AU - Pablo Alonso-Coello AU - Alastair D Hay TI - Post-consultation acute respiratory tract infection recovery: a latent class-informed analysis of individual patient data AID - 10.3399/BJGP.2022.0229 DP - 2023 Mar 01 TA - British Journal of General Practice PG - e196--e203 VI - 73 IP - 728 4099 - http://bjgp.org/content/73/728/e196.short 4100 - http://bjgp.org/content/73/728/e196.full SO - Br J Gen Pract2023 Mar 01; 73 AB - Background There is a lack of evidence regarding post-consultation symptom trajectories for patients with respiratory tract infections (RTIs) and whether patient characteristics can be used to predict illness duration.Aim To describe symptom trajectories in patients with RTIs, and assess baseline characteristics and adverse events associated with trajectories.Design and setting The study included data about 9103 adults and children from 12 primary care studies.Method A latent class-informed regression analysis of individual patient data from randomised controlled trials and observational cohort studies was undertaken. Post-consultation symptom trajectory (severity and duration), re-consultation with same or worsening illness, and admission to hospital were assessed.Results In total, 90% of participants recovered from all symptoms by 28 days, regardless of antibiotic prescribing strategy (none, immediate, and delayed antibiotics). For studies of RTI with cough as a dominant symptom (n = 5314), four trajectories were identified: ‘rapid (6 days)’ (90% of participants recovered within 6 days) in 52.0%; ‘intermediate (10 days)’ (28.9%); ‘slow progressive improvement (27 days)’ (12.5%); and ‘slow improvement with initial high symptom burden (27 days)’ (6.6%). For cough, being aged 16–64 years (odds ratio [OR] 2.57, 95% confidence interval [CI] = 1.72 to 3.85 compared with <16 years), higher presenting illness baseline severity (OR 1.51, 95% CI = 1.12 to 2.03), presence of lung disease (OR 1.78, 95% CI = 1.44 to 2.21), and median and above illness duration before consultation (≥7 days) (OR 1.99, 95% CI = 1.68 to 2.37) were associated with slower recovery (>10 days) compared with faster recovery (≤10 days). Re-consultations and admissions to hospital for cough were higher in those with slower recovery (ORs: 2.15, 95% CI = 1.78 to 2.60 and 7.42, 95% CI = 3.49 to 15.78, respectively).Conclusion Older patients presenting with more severe, longer pre-consultation symptoms and chronic lung disease should be advised they are more likely to experience longer post-consultation illness durations, and that recovery rates are similar with and without antibiotics.