抗生素对普通呼吸道感染严重并发症的保护作用：英国全科医疗研究资料库的回顾性队列研究

目的确定抗生素降低普通呼吸道感染严重并发症的风险程度。设计回顾性队列研究。地点组成全科医疗研究数据库的英国初级医疗服务机构。资料来源336万人次呼吸道感染。主要转归指标诊断后1个月内，治疗和不治疗的患者严重并发症的风险：包括中耳炎后乳突炎，咽喉炎后的扁桃体周脓肿，上呼吸道感染和胸部感染后的肺炎。为减少1例并发症所需治疗的患者数。结果上呼吸道感染、咽喉炎和中耳炎后的严重并发症很少见，需要治疗的例数（NNT）超过4000。胸部感染后肺炎的风险很高，特别是老年人，使用抗生素可以明显减少风险。为减少1例并发症，在≥65岁的人群需要治疗的患者数为39，年轻人群为96～119。结论抗生素治疗不能减少上呼吸道感染、咽喉炎和中耳炎后发生严重并发症的风险。抗生素可以明显降低胸腔感染后肺炎的风险，特别是在风险最大的老年人群。

Protective effect of antibiotics against serious complications of common respiratory tract infections： retrospective cohort study with the UK General Practice Research Database

Objective To determine the extent to which antibiotics reduce the risk of serious complications after common respiratory tract infections. Design Retrospective cohort study. Setting UK primary care practices contributing to the general practice research database. Data source 3. 36 million episodes of respiratory tract infection. Main outcome measures Risk of serious complications in treated and untreated patients in the month after diagnosis： mastoiditis after otitis media, quinsy after sore throat, and pneumonia after upper respiratory tract infection and chest infection. Number of patients needed to treat to prevent one complication. Results Serious complications were rare after upper respiratory tract infections, sore throat, and otitis media, and the number needed to treat was over 4000. The risk of pneumonia after chest infection was high, particularly in elderly people, and was substantially reduced by antibiotic use, with a number needed to treat of 39 for those aged≥6.5 and 96-119 in younger age groups. Conclusion Antibiotics are not justified to reduce the risk of serious complications for upper respiratory tract infection, sore throat, or otitis media. Antibiotics substantially reduce the risk of pneumonia after chest infection, particularly in elderly people in whom the risk is highest.