scholarly journals Antibiotic prescriptions in the context of suspected bacterial respiratory tract superinfections in the COVID-19 era: a retrospective quantitative analysis of antibiotic consumption and identification of antibiotic prescription drivers

2021 ◽  
Author(s):  
J. Van Laethem ◽  
S. Wuyts ◽  
S. Van Laere ◽  
J. Koulalis ◽  
M. Colman ◽  
...  
Keyword(s):  
Quantitative Analysis ◽  
Respiratory Tract ◽  
Antibiotic Prescription ◽  
Antibiotic Consumption

scholarly journals Patterns of Antibiotic Prescription in Children: Tirana, Albania Region

2018 ◽  
Vol 6 (4) ◽  
pp. 719-722 ◽  
Author(s):  
Joana Mihani ◽  
Suela Këlliçi
Keyword(s):  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Therapeutic Agent ◽  
Antibiotic Prescription ◽  
Antibiotic Consumption ◽  
Inclusion Criteria ◽  
Cross Sectional ◽  
Common Diagnosis ◽  
Tract Infections

BACKGROUND: Antibiotics (abx) constitute the most prescribed therapeutic agent in the world. There is little data regarding antibiotic consumption by young children in Albania.AIM: This study aims to evaluate antibiotic prescription in children in quantitative and qualitative terms, and therefore, propose recommendations to improve overall clinical outcomes.METHODS: A retrospective, cross-sectional drug utilisation study was conducted based on unreimbursed prescriptions collected in 25 pharmacies, randomly selected within the district of Tirana, during the period beginning December 2015 to January 2016. They contain at least one antibacterial therapeutic agent prescribed for children 0-15 years old, for systemic use. The data were analysed using SPSS 20.RESULTS: A group of 904 prescriptions meet inclusion criteria, 54.1% patient were female, and 45.9% were male. The most exposed age group were 2-6 years old. The most common diagnosis was respiratory tract infections: bronchitis (59.2%), tonsillitis (17%) followed by bronchopneumonia (9.6%). The most prescribed antibiotic classes are Penicillins (33%), Cephalosporins (33.2%) and Macrolides (21,5%). Amoxicillin (19.4%), Azithromycin (14.7%), the combination of Amoxicillin and Clavulanic acid (13.5%) and Cefaclor (11.7%) were the most commonly prescribed. We observed short duration therapies, with a mean duration of 5.21 days and in 17.4 % of cases with a duration of ≤ 2 days.CONCLUSIONS: We observed a large use of broad-spectrum antibiotics for common respiratory tract infection in children less than 6 years old. We would recommend the creation of an electronic database of patient’s record in order to monitor the quality of prescription and education of the healthcare professionals and patient of risks related to antibiotic resistance.

scholarly journals Competition in primary care and prescription of antibiotics in Norway

2020 ◽  
Author(s):  
Yana Zykova
Keyword(s):  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Antibiotic Prescription ◽  
Average Length ◽  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
Potential Link ◽  
Tract Infections ◽  
Resistance Rates ◽  
And Control

Appropriate use of antibiotics is an important strategy to combat the problem of growing antibiotic resistance rates. In order to follow this strategy, it is important to understand the determinants of antibiotic use. We analyse the potential link between competition among general practitioners (GPs) measured with the Herfindahl-Hirshman index (HHI) and regional antibiotic consumption in Norway in 2015 and 2016. We use the data about antibiotic consumption expressed by the number of prescriptions of antibiotics for systemic use (J01) and by the number of antibiotics for respiratory tract infections (phenoxymethylpenicillin (J01CE02), doxycycline (J01AA02), amoxicillin (J01CA04) and macrolides (J01FA)) per 1000 inhabitants. We apply multiple regression analysis to the data mentioned above and control for socioeconomic characteristics of the municipalities. Our findings suggest that competition may contribute to about 37-80 additional antibiotic prescriptions per 1000 inhabitants per year and 23-46 additional prescriptions per 1000 inhabitants of antibiotics for respiratory tract infections. Moreover, our estimations suggest that antibiotic prescription is significantly related to the average number of consultations per patient, the average length of the patient list, travel time to a pharmacy, income, and the share of women.

Antibiotic consumption and susceptibility of isolates in patients with low respiratory tract infection

Pneumologie ◽  
2015 ◽  
Vol 69 (S 01) ◽  
Author(s):  
EJS Hurtado ◽  
MJG Fernández ◽  
AA Arregosa ◽  
JM González Miret ◽  
MZ Rascón ◽  
...  
Keyword(s):  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Antibiotic Consumption

scholarly journals Cost-Effectiveness Analysis of the Use of Point-of-Care C-Reactive Protein Testing to Reduce Antibiotic Prescribing in Primary Care

Antibiotics ◽  
2018 ◽  
Vol 7 (4) ◽  
pp. 106 ◽  
Author(s):  
Emily Holmes ◽  
Sharman Harris ◽  
Alison Hughes ◽  
Noel Craine ◽  
Dyfrig Hughes
Keyword(s):  
Primary Care ◽  
Cost Effectiveness ◽  
Respiratory Tract ◽  
Clinical Guidelines ◽  
Antibiotic Prescription ◽  
Point Of Care ◽  
Cost Effective ◽  
Routine Practice ◽  
C Reactive Protein ◽  
Reactive Protein

More appropriate and measured use of antibiotics may be achieved using point-of-care (POC) C-reactive protein (CRP) testing, but there is limited evidence of cost-effectiveness in routine practice. A decision analytic model was developed to estimate the cost-effectiveness of testing, compared with standard care, in adults presenting in primary care with symptoms of acute respiratory tract infection (ARTI). Analyses considered (1) pragmatic use of testing, reflective of routine clinical practice, and (2) testing according to clinical guidelines. Threshold and scenario analysis were performed to identify cost-effective scenarios. In patients with symptoms of ARTI and based on routine practice, the incremental cost-effectiveness ratios of CRP testing were £19,705 per quality-adjusted-life-year (QALY) gained and £16.07 per antibiotic prescription avoided. Following clinical guideline, CRP testing in patients with lower respiratory tract infections (LRTIs) cost £4390 per QALY gained and £9.31 per antibiotic prescription avoided. At a threshold of £20,000 per QALY, the probabilities of POC CRP testing being cost-effective were 0.49 (ARTI) and 0.84 (LRTI). POC CRP testing as implemented in routine practice is appreciably less cost-effective than when adhering to clinical guidelines. The implications for antibiotic resistance and Clostridium difficile infection warrant further investigation.

scholarly journals Respiratory Tract Infection Management and Antibiotic Prescription in Children

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Koen J. van Aerde ◽  
Liza de Haan ◽  
Mattijn van Leur ◽  
Gerardus P. Gerrits ◽  
Henk Schers ◽  
...  
Keyword(s):  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Antibiotic Prescription ◽  
Infection Management

scholarly journals Evaluation of Procalcitonin Use in Patients Discharged from the Emergency Department with Acute Respiratory Infection

2021 ◽  
Vol 1 (S1) ◽  
pp. s33-s34
Author(s):  
Garrett Fontaine ◽  
David Banach ◽  
Jeffrey Aeschlimann
Keyword(s):  
Clinical Characteristics ◽  
Respiratory Infections ◽  
Antibiotic Prescription ◽  
Severity Of Illness ◽  
Severe Infection ◽  
Retrospective Chart Review ◽  
Study Groups ◽  
Antibiotic Consumption ◽  
Outcome Variable ◽  
Patients At Risk

Background: Acute respiratory infections (ARIs) contribute significantly to inappropriate antimicrobial prescription. The rate of such prescriptions in US emergency departments (EDs) has remained stable over time. The use of procalcitonin (PCT) testing has been shown to lower risk of mortality and to reduce antibiotic consumption. It also has the potential to aid ED physicians in stratifying ARI patients who may require antibiotics but do not require hospital admission. In this study, we described the characteristics and proportion of antibiotic prescription in patients evaluated in and discharged from the ED with ARI. Methods: We performed a retrospective chart review of patients diagnosed with ARI and discharged from a single academic ED between January 2018 and January 2020. We compared those for whom a PCT test was ordered to those without a PCT test ordered at ARI diagnosis. Charts were reviewed until there were 110 subjects in each of the 2 study groups. The main outcome variable was receipt of an antibiotic prescription. The χ2 test was used to compare the proportion of patients who received an antibiotic prescription, demographics, and clinical characteristics between the 2 groups. The Mann-Whitney U test was used to compare the distribution of ages between the 2 groups. Results: Among patients in the PCT group, 87 (79.0%) received antibiotics versus 69 (62.7%) in the non-PCT group (P ± 18.8 vs 52.7 years ± 17.6; P = .0002); more likely to have preexisting heart and lung disease (28.2% vs 15.5%; P = .02); more often male (58.2% vs 40%; p < 0.01); had more subjective fevers (47.3% vs 33.6%, p=0.04), sputum production (49.1% vs 28.2%, p < 0.01), and nausea (17.3% vs 8.2%, p=0.04). PCT results were low (≤0.25) in 82.7% (91) of patients, of whom 70.3% (64) received antibiotics. Conclusions: Patients for whom PCT testing was ordered were older, had more underlying conditions and increased severity of illness. This finding may reflect that PCT testing was more likely to be ordered in patients at risk of severe infection but not requiring admission. The proportion of antibiotics prescriptions was higher for patients who had a PCT test. For patients with a low PCT result, the proportion of patients prescribed antibiotics was high. This finding may suggest that clinical characteristics were more influential than PCT result in the decision to prescribe antibiotics. More research is needed on the role of PCT testing in antibiotic prescription decisions for patients presenting to the ED with ARI.Funding: NoDisclosures: None

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