Stefan Malmberg´s research

Respiratory tract infections – diagnostics, treatment and complications

Respiratory tract infections are a common reason to contact primary care. Antibiotic treatment should be avoided for harmless infections, considering the growing problem of antibiotic resistance. However, it is essential to identify life-threatening conditions that may present with a sore throat or cough.

Respiratory tract infections, with symptoms such as a sore throat or cough, are among the most common reasons to contact primary care. Harmless and self-healing infections dominate this group of patients. It is essential to avoid unnecessary antibiotic treatment considering the growing problem of antibiotic resistance. However, it is crucial to identify potentially life-threatening conditions that may present with a sore throat or cough. Examples of such serious infections are Lemierre’s syndrome and pneumonia.

The first project is a systematic literature review with meta-analysis regarding Fusobacterium necrophorum to clarify its role as a pathogen in uncomplicated pharyngotonsillitis.

The second project aims at developing an ASP (Antimicrobial Stewardship Program) and evaluating if this intervention can increase adherence to the guidelines for diagnostics and treatment of pharyngotonsillitis in primary health care.

The third project is a cross-sectional survey investigation if there is an association between different local guidelines in five countries (Australia, Germany, Sweden, UK, and the USA) and their medical practitioners’ perception of best management for patients attending with an uncomplicated acute sore throat.

The objective of the fourth project is to evaluate the accuracy and precision of a novel method for non-contact measurement of four vital signs, which are relevant when assessing the severity and prognosis of infectious diseases (heart rate, blood oxygen saturation, respiratory rate, and blood pressure).

The first project is a systematic literature review and meta-analysis regarding Fusobacterium necrophorum to clarify its role as a pathogen in uncomplicated pharyngotonsillitis.

For the second project, the investigators developed an antibiotic stewardship program (ASP) to increase adherence to the Swedish guidelines for managing patients with a sore throat. The method is a randomized controlled trial where primary health care centers are randomized to get the ASP or not. The adherence to the Swedish guidelines is measured 6 months before and after implementation of the ASP. The ASP consists of educational meetings at the clinic for medical practitioners and nurses being informed about current guidelines, seeing their clinic’s adherence to the guidelines as well as discussing cases.

The third project is a cross-sectional survey investigation if there is an association between different local guidelines in five countries (Australia, Germany, Sweden, UK, and the USA) and their medical practitioners’ perception of best management for patients attending the primary health care with an uncomplicated acute sore throat.

In the fourth project, a method-comparison study design will be used to compare each vital sign measured with the novel method to the corresponding reference “gold standard” method in a sample of healthy volunteers.

The first project: A systematic review and compilation of the current evidence concerning FN in pharyngotonsillitis is relevant when designing clinical guidelines about the management, especially when the passage of events deviates from the expected course.

The second project: If the results show that this ASP leads to increased adherence to the guidelines for the management of pharyngotonsillitis, implementing this ASP could lead to the more rational use of antibiotics.

The third project: It is valuable to outline GP’s perceptions of appropriate management in relation to the local guidelines for the management of patients attending with an uncomplicated acute sore throat, thereby contributing to the understanding of what kind of education and training should be considered.

The fourth project: The proposed study is expected to show whether the novel method returns results that are in agreement with the reference methods, in which case it can provide excellent support when assessing priority, severity, and prognosis of infections.


University of Gothenburg

Supervisor: Pär-Daniel Sundvall, Associate Professor, University of Gothenburg