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Acute cough is one of the most common symptoms managed in primary care. The vast majority of patients presenting with cough suffer from an uncomplicated (presumably viral) lower respiratory tract infection (LRTI), but a considerable proportion are prescribed antibiotics for suspected pneumonia. Most of these prescriptions are unnecessary or even harmful, but discriminating pneumonia from uncomplicated LRTI on clinical grounds alone is not trivial.
To shed light on this issue, investigators have conducted a prospective cohort study involving 28,883 adult patients with acute cough attributed to LRTI who were recruited from 5,222 practices in the U.K. between 2009 and 2013. Of this cohort, 720 (2.5%) had a chest x-ray taken within the first 7 d…