scholarly journals Antibiotic Prescription Rates for Acute Respiratory Tract Infections in US Ambulatory Settings

JAMA ◽  
2009 ◽  
Vol 302 (7) ◽  
pp. 758 ◽  
Author(s):  
Carlos G. Grijalva
Keyword(s):  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Antibiotic Prescription ◽  
Acute Respiratory Tract Infections ◽  
Prescription Rates ◽  
Tract Infections

scholarly journals Impact of a clinical decision rule on antibiotic prescription for children with suspected lower respiratory tract infections presenting to European emergency departments: a simulation study based on routine data

2021 ◽  
Author(s):  
Nienke N Hagedoorn ◽  
Josephine H L Wagenaar ◽  
Daan Nieboer ◽  
David Bath ◽  
Ulrich Von Both ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Antibiotic Prescription ◽  
Routine Data ◽  
Clinical Decision ◽  
Intermediate Risk ◽  
Clinical Decision Rule ◽  
Lower Respiratory Tract Infections ◽  
Prescription Rates ◽  
Tract Infections

Abstract Background Discriminating viral from bacterial lower respiratory tract infections (LRTIs) in children is challenging thus commonly resulting in antibiotic overuse. The Feverkidstool, a validated clinical decision rule including clinical symptoms and C-reactive protein, safely reduced antibiotic use in children at low/intermediate risk for bacterial LRTIs in a multicentre trial at emergency departments (EDs) in the Netherlands. Objectives Using routine data from an observational study, we simulated the impact of the Feverkidstool on antibiotic prescriptions compared with observed antibiotic prescriptions in children with suspected LRTIs at 12 EDs in eight European countries. Methods We selected febrile children aged 1 month to 5 years with respiratory symptoms and excluded upper respiratory tract infections. Using the Feverkidstool, we calculated individual risks for bacterial LRTI retrospectively. We simulated antibiotic prescription rates under different scenarios: (1) applying effect estimates on antibiotic prescription from the trial; and (2) varying both usage (50%–100%) and compliance (70%–100%) with the Feverkidstool’s advice to withhold antibiotics in children at low/intermediate risk for bacterial LRTI (≤10%). Results Of 4938 children, 4209 (85.2%) were at low/intermediate risk for bacterial LRTI. Applying effect estimates from the trial, the Feverkidstool reduced antibiotic prescription from 33.5% to 24.1% [pooled risk difference: 9.4% (95% CI: 5.7%–13.1%)]. Simulating 50%–100% usage with 90% compliance resulted in risk differences ranging from 8.3% to 15.8%. Our simulations suggest that antibiotic prescriptions would be reduced in EDs with high baseline antibiotic prescription rates or predominantly (>85%) low/intermediate-risk children. Conclusions Implementation of the Feverkidstool could reduce antibiotic prescriptions in children with suspected LRTIs in European EDs.

scholarly journals Knowledge, Attitude and Practice of Family Physicians on Antimicrobial Therapy for Acute Respiratory Tract Infections - A Study from Istanbul, Turkey

2021 ◽  
Vol 10 (2) ◽  
pp. 49-55
Author(s):  
Guzin Zeren Ozturk ◽  
Dilek Toprak ◽  
Osman Sagsoz ◽  
Cuneyt Ardic
Keyword(s):  
Respiratory Tract ◽  
Primary Care Physicians ◽  
Respiratory Tract Infections ◽  
Antibiotic Prescription ◽  
Acute Otitis Media ◽  
Family Physicians ◽  
Online Questionnaire ◽  
Acute Respiratory Tract Infections ◽  
Significant Difference ◽  
Tract Infections

Aim: We aimed to investigate the knowledge, attitude, practice of family physicians regarding an-timicrobial therapy in acute respiratory tract infections. Methods: After receiving the ethics committee approval, the data were collected by online questionnaire from a phone application with 304 physicians. Questions about socio-demographic features and knowledge, attitude, and practices on antibiotics use were asked. Using SPSS, we did the statistical analyses with appropriate procedures. Results: Among the participants, 127 (41.8%) were specialists, and 177 (58.2%) were gen-eral practitioners. The specialists gave correct answers about tonsillopharyngitis and bron-chiolitis significantly more often than the general practitioners did. The antibiotic choices for acute otitis media were not in compliance with the guidelines of the Centers for Disease Control, and between the groups, there was no significant difference in terms of initial antibiotic choice. The self-reported antibiotic prescription rate was 25%. In 10%, the most common perceived reason for inappropriate antibiotic prescription was pressure from patients. Conclusion: There remains considerable misuse of antibiotics by primary care physicians for acute respiratory tract infections. Education of physicians and patients regarding acute respiratory tract infections may be needed to lower the rate of inappropriate antibiotic pre-scriptions. Keywords: public health practice, practice patterns, primary healthcare

scholarly journals Changes in antibiotic prescription following an education strategy for acute respiratory infections

2021 ◽  
Vol 31 (1) ◽  
Author(s):  
Eloisa Delsors ◽  
Francisco Monsó ◽  
Francisco Javier López-Román ◽  
Juan Francisco Menárguez-Puche ◽  
María Gonzalez-Barberá ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Primary Care Physicians ◽  
Respiratory Tract Infections ◽  
Respiratory Infections ◽  
Antibiotic Prescription ◽  
Daily Practice ◽  
Acute Respiratory Tract Infections ◽  
Rapid Antigen Detection Test ◽  
Tract Infections ◽  
The Impact

AbstractThe objective of this study was to assess the impact of an education intervention for primary health care physicians, based on the knowledge of clinical practice guidelines and availability of rapid antigen detection test for group A streptococci (GAS), on the improvement of antibiotic prescription for patients with acute respiratory tract infections. Before and after the intervention, physicians collected data from ten consecutive patients who attended during a 3-week period. This process was performed twice a year for 6 consecutive years (2012–2017). A total of 18,001 patients were visited by 391 primary care physicians during the study period, 55.6% before intervention and 44.4% after intervention. After intervention, the antibiotic prescription decreased significantly, from 33.0 to 23.4% (p < 0.01). However, there was a statistically significant increase (p < 0.01) in the use of penicillins. This study, carried out in daily practice conditions, confirms that the educational strategy was associated with an overall reduction in the use of antibiotics and an improvement in the antibiotic prescription profile in acute respiratory tract infections.

scholarly journals Extracellular amoebal-vesicles: potential transmission vehicles for respiratory viruses

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Rafik Dey ◽  
Melanie A. Folkins ◽  
Nicholas J. Ashbolt
Keyword(s):  
Respiratory Syncytial Virus ◽  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Respiratory Viruses ◽  
Environmental Persistence ◽  
Viral Dissemination ◽  
Acute Respiratory Tract Infections ◽  
High Concentrations ◽  
Syncytial Virus ◽  
Tract Infections

AbstractHuman respiratory syncytial virus (RSV) is a major cause of acute respiratory tract infections in children and immunocompromised adults worldwide. Here we report that amoebae-release respirable-sized vesicles containing high concentrations of infectious RSV that persisted for the duration of the experiment. Given the ubiquity of amoebae in moist environments, our results suggest that extracellular amoebal-vesicles could contribute to the environmental persistence of respiratory viruses, including potential resistance to disinfection processes and thereby offering novel pathways for viral dissemination and transmission.

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