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NPJ Prim Care Respir Med. 2015 Mar 12;25:15010. doi: 10.1038/npjpcrm.2015.10.

Suspected community-acquired pneumonia in an ambulatory setting (CAPA): a French prospective observational cohort study in general practice.

Author information

1
Département de médecine générale, Faculté de médecine, Sorbonne Paris Cité, Université Paris Descartes, Paris, France.
2
Service d'informatique médicale et de biostatistique, Hôpital Necker Enfants Malades, Paris, France.
3
1] Département de médecine générale, Faculté de médecine, Sorbonne Paris Cité, Université Paris Descartes, Paris, France [2] Collège National des Généralistes Enseignants (CNGE), France.
4
Equipe d'accueil 24-15, Institut Universitaire de Recherche Clinique, Université Montpellier 1, Montpellier, France.
5
Inserm Umrs 1142 LIMICS, Centre de Recherche des Cordeliers, Université Pierre et Marie Curie, UPMC, Paris, France.

Abstract

BACKGROUND:

Few studies have addressed the pragmatic management of ambulatory patients with suspected community-acquired pneumonia (CAP) using a precise description of the disease with or without chest X-ray (X-ray) evidence.

AIMS:

To describe the characteristics, clinical findings, additional investigations and disease progression in patients with suspected CAP managed by French General Practitioners (GPs).

METHODS:

The patients included were older than 18 years, with signs or symptoms suggestive of CAP associated with recent-onset unilateral crackles on auscultation or a new opacity on X-ray. They were followed for up to 6 weeks. Descriptive analyses of all patients and according to their management with X-rays were carried out.

RESULTS:

From September 2011 to July 2012, 886 patients have been consulted by 267 GPs. Among them, 278 (31%) were older than 65 years and 337 (38%) were at increased risk for invasive pneumococcal disease. At presentation, the three most common symptoms, cough (94%), fever (93%), and weakness or myalgia (81%), were all observed in 70% of patients. Unilateral crackles were observed in 77% of patients. Among patients with positive radiography (64%), 36% had no unilateral crackles. A null CRB-65 score was obtained in 62% of patients. Most patients (94%) initially received antibiotics and experienced uncomplicated disease progression regardless of their management with X-rays. Finally, 7% of patients were hospitalised and 0.3% died.

CONCLUSIONS:

Most patients consulting GPs for suspected CAP had the three following most common symptoms: cough, fever, and weakness or myalgia. More than a third of them were at increased risk for invasive pneumococcal disease. With or without X-rays, most patients received antibiotics and experienced uncomplicated disease progression.

PMID:
25763466
PMCID:
PMC4373492
DOI:
10.1038/npjpcrm.2015.10
[Indexed for MEDLINE]
Free PMC Article

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