Recurrent respiratory infections without known lung disease Referral Access Criteria
Recurrent respiratory infections without known lung disease Referral Access Criteria
Referrers should use this page when referring patients to public adult respiratory and sleep medicine outpatient services for recurrent respiratory infections without known lung disease.
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| Emergency referral |
 If any of the following are present or suspected, refer the patient to the emergency department or seek emergency medical advice if in a remote region. |
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| Clinical indications for outpatient referral |
If any of these issues are present, refer to outpatient services through the Central Referral Service (CRS).
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- More than 3-4 presentations of lower respiratory infections requiring antibiotics in the past 12 months
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| Mandatory information |
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Referrals missing 'mandatory information' with no explanation provided may not be accepted by site. If 'mandatory information' is not included, the explanation must be provided in the body of the referral (e.g. patient unable to access test in regional or remote areas or due to financial reason).
This information is required to inform accurate and timely triage. If unable to attach reports, please include relevant information/findings in the body of the referral and advise where (provider) investigation/imaging was completed.
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| History |
- Relevant history, onset, duration, and description of lower respiratory tract symptoms
- Details of previous treatment and outcome including details of antibiotics previously prescribed for respiratory tract infections
- Related history of immunosuppression
- Current medication list
- Any known allergies
- Smoking/vaping status and history
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| Examination |
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| Investigations |
- Spirometry, with inclusion of flow volume loop (where possible)
- Sputum culture
- FBC
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| Highly desirable |
| History |
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| Examination |
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| Investigations |
- WCC (if has already been performed)
- CXR (if has already been performed)
- CT chest
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| Indicative clinical urgency category |
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Category 1
Appointment within 30 days
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- No defined category 1 criteria
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Category 2
Appointment within 90 days
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- More than 3-4 presentations of lower respiratory infections requiring antibiotics in the past 12 months
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Category 3
Appointment within 365 days
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- No defined category 3 criteria
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| Useful information |
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- Please consider that most adults with recurrent lower respiratory infection will have COPD, bronchiectasis, or aspiration
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Spirometry for recurrent chest infections is looking for underlying airways disease that makes patients more prone to have exacerbations or chest infections. Airways disease such as asthma, COPD and/or bronchiectasis with airflow changes are more readily diagnosed on spirometry. Appropriate diagnosis and management of airways disease is therefore important aspect of managing recurrent infections. CXR is not particularly helpful except during the acute episode to check for pneumonia. CT is to look for any structural abnormality but can miss airways disease unless lung function is also assessed.
Spirometry: Bulk-billed spirometry can be obtained via Respiratory Care WA (external site). A list of other providers undertaking lung function testing is provided on Clinician Assist WA: Respiratory Function Testing (external site).
See MBS: Item 11505 (external site) and MBS: Item 11506 (external site) for information on completing spirometry.
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