Arch Intern Med
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Trimethoprim-sulfamethoxazole has consistently been the recommended drug for uncomplicated urinary tract infections in women. Which antibiotics physicians use has implications for patient outcomes, antimicrobial resistance, and costs. ⋯ Ambulatory care physicians are increasing their use of fluoroquinolones and nitrofurantoin, even though they are not highly recommended and not the most cost-effective. Antibiotic prescribing in urinary tract infections may be influenced by clinical factors such as pregnancy and drug allergies but may also be shaped by nonclinical factors such as subspecialty culture.
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Simple markers for evaluating the severity of lower respiratory tract infections (LRTI) in primary care are lacking. It is of value to examine whether the information available to the primary care physician during a patient's initial visit can be used to assess the severity of LRTI. ⋯ Preceding aggravation of a concurrent illness and respiratory rate of 25/min or higher, together with an elevated serum CRP level (> or = 100 mg/L), can be used as simple markers for identifying patients with the highest risk for LRTI and improve management decisions among elderly people in primary care.