scholarly journals Antibiotic prescription in primary care from the perspective of family physicians: a qualitative study

2021 ◽  
Vol 15 (08) ◽  
pp. 1117-1123
Author(s):  
Salih Hosoglu ◽  
Annika Yanina Classen ◽  
Zekeriya Akturk
Keyword(s):  
Primary Care ◽  
Social Status ◽  
Antibiotic Prescription ◽  
Public Awareness ◽  
Family Physicians ◽  
Antibiotic Use ◽  
Patient Expectations ◽  
Medical Decision ◽  
Antibiotic Prescribing ◽  
The Social

Introduction: Antibiotic consumption increases worldwide steadily. Turkey is now top on the list of global consumption and became a prototype of excessive use of antibiotics. In the last two decades, family physicians (FPs) have become key figures in the healthcare system. This study aims to understand the reasons for inappropriate antibiotic prescribing and elicit suggestions for improving antibiotic use in primary care from doctors themselves. Methodology: This is a qualitative semi-structured interview study with research dialogues guided by the Vancouver School of interpretive phenomenology. Fourteen FPs from different parts of Turkey were questioned on inappropriate antibiotic prescriptions and their suggestions for improving antibiotic use. Results: The most important reasons for prescribing antibiotics without acceptable indications were patient expectations, defensive medical decision making, constraints due to workload, and limited access to laboratories. The most remarkable inference was the personal feeling of an insecure job environment of the FPs. The most potent suggestions for improving the quality of antibiotic prescription were public campaigns, improvements in the diagnostic infrastructures of primary care centers, and enhancing the social status of FPs. The FPs expressed strong concerns related to the complaints that patients make to administrative bodies. Conclusions: Primary care physicians work under immense pressure, stemming mainly from workload, patient expectations, and obstacles related to diagnostic processes. Improving the social status of physicians, increasing public awareness, and the facilitation of diagnostic procedures was the methods suggested for increasing antibiotic prescription accuracy.

scholarly journals Antibiotic prescription in primary care from the perspective of family physicians: a qualitative study

2020 ◽  
Author(s):  
Salih Hosoglu ◽  
Annika Yanina Claßen
Keyword(s):  
Primary Care ◽  
Decision Making ◽  
Qualitative Study ◽  
Social Status ◽  
Antibiotic Prescription ◽  
Family Physicians ◽  
Antibiotic Use ◽  
Patient Expectations ◽  
Medical Decision ◽  
The Social

Abstract Background Antibiotic consumption rates increase worldwide steadily. Turkey is now top on the list of global consumption and a prototype of excessive use of antibiotics. In the last two-decades, family physicians (FPs) have become key figures in the healthcare system. The aim of this study is to understand the reasons for inappropriate prescription and to elicit suggestions for ways of improving antibiotic use in primary care from doctors themselves.Methods This is a qualitative study using semi-structured interviews with key individuals. Fourteen FPs from different parts of Turkey participated in these interviews. They were questioned on major indications for antibiotic prescription, reasons for inappropriate antibiotic prescription, obstacles to decision making in antibiotic use and their suggestions for improving antibiotic use. The interviews were recorded, transcribed, and analyzed for common themes. Thematic coding was used in the formulation of themes.Results Interviewees emphasized the coercive factors that lead to inappropriate antibiotic prescription: patient expectations, defensive medical decision making, constraints due to workload and limited access to laboratories. The most powerful suggestions for improving the quality of antibiotic prescription were public campaigns, improvements in the diagnostic infrastructures of primary care centers and enhancing the social status of FPs. The FPs expressed strong concerns related to the complaints that patients make to administrative bodies. Conclusions Physicians in primary care work under immense pressure stemming mainly from workload, patient expectations and obstacles to diagnostic processes. Improving the social status of physicians, increasing public awareness and the facilitation of diagnostic procedures were the methods suggested for increasing antibiotic prescription accuracy.

scholarly journals Impact of the COVID-19 Pandemic on Antibiotic Prescribing for Common Infections in The Netherlands: A Primary Care-Based Observational Cohort Study

Antibiotics ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 196
Author(s):  
Alma C. van de Pol ◽  
Josi A. Boeijen ◽  
Roderick P. Venekamp ◽  
Tamara Platteel ◽  
Roger A. M. J. Damoiseaux ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Primary Care ◽  
Health Care ◽  
Antibiotic Prescription ◽  
Antibiotic Use ◽  
Antibiotic Prescribing ◽  
Skin Infections ◽  
Prescription Rates ◽  
Ear Infections ◽  
Disease Entities

In 2020, the COVID-19 pandemic brought dramatic changes in the delivery of primary health care across the world, presumably changing the number of consultations for infectious diseases and antibiotic use. We aimed to assess the impact of the pandemic on infections and antibiotic prescribing in Dutch primary care. All patients included in the routine health care database of the Julius General Practitioners’ Network were followed from March through May 2019 (n = 389,708) and March through May 2020 (n = 405,688). We extracted data on consultations for respiratory/ear, urinary tract, gastrointestinal and skin infections using the International Classification of Primary Care (ICPC) codes. These consultations were combined in disease episodes and linked to antibiotic prescriptions. The numbers of infectious disease episodes (total and those treated with antibiotics), complications, and antibiotic prescription rates (i.e., proportion of episodes treated with antibiotics) were calculated and compared between the study periods in 2019 and 2020. Fewer episodes were observed during the pandemic months than in the same months in 2019 for both the four infectious disease entities and complications such as pneumonia, mastoiditis and pyelonephritis. The largest decline was seen for gastrointestinal infections (relative risk (RR), 0.54; confidence interval (CI), 0.51 to 0.58) and skin infections (RR, 0.71; CI, 0.67 to 0.75). The number of episodes treated with antibiotics declined as well, with the largest decrease seen for respiratory/ear infections (RR, 0.54; CI, 0.52 to 0.58). The antibiotic prescription rate for respiratory/ear infections declined from 21% to 13% (difference −8.0% (CI, −8.8 to −7.2)), yet the prescription rates for other infectious disease entities remained similar or increased slightly. The decreases in primary care infectious disease episodes and antibiotic use were most pronounced in weeks 15–19, mid-COVID-19 wave, after an initial peak in respiratory/ear infection presentation in week 11, the first week of lock-down. In conclusion, our findings indicate that the COVID-19 pandemic has had profound effects on the presentation of infectious disease episodes and antibiotic use in primary care in the Netherlands. Consequently, the number of infectious disease episodes treated with antibiotics decreased. We found no evidence of an increase in complications.

scholarly journals 1345. Impact of the COVID-19 Pandemic on Pediatric Ambulatory Antibiotic Use in an Academic Health System

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S683-S684
Author(s):  
Sophie E Katz ◽  
Hillary Spencer ◽  
Jim Zhang ◽  
Ritu Banerjee ◽  
Ritu Banerjee
Keyword(s):  
Primary Care ◽  
Antibiotic Prescription ◽  
Medical Center ◽  
Antibiotic Use ◽  
Urgent Care ◽  
Antibiotic Prescribing ◽  
Provider Type ◽  
Prescription Rates ◽  
Student’S T ◽  
Almost All

Abstract Background It is unclear how the COVID-19 pandemic has impacted outpatient pediatric antibiotic prescribing. Methods We compared diagnoses and antibiotic prescription rates for children pre- vs post-COVID-19 in 5 ambulatory settings affiliated with Vanderbilt University Medical Center: emergency department (ED), urgent care clinics (including pediatric-only after-hours clinics [AHC]s and walk-in clinics [WIC] for all ages), primary care clinics (PCC), and retail health clinics (RHC). Time periods were pre-COVID-19 3/1/19 – 5/15/19 (P1); and post-COVID-19 3/1/20 – 5/15/20 (P2). Diagnoses and percent of encounters with an antibiotic prescription were analyzed by encounter (in-person vs telemedicine [TMed]), clinic and provider type. We also interviewed 16 providers about perceived COVID-19 impact on pediatric ambulatory antibiotic prescribing. Student’s T and χ 2 tests were used as appropriate. Results The number of pediatric ambulatory visits was 16671 in P1 and 7010 in P2. There were no TMed visits in P1 vs 188 in P2 (2.7% of total P2 visits); 186 (99% of TMed visits) were in PCC (Table). In all settings, the number of encounters was lower in P2 vs P1 (p< 0.001). The percent of encounters with an antibiotic prescription was lower in P2 (32%) than in P1 (38.2%) (p< 0.001) (Table) overall and in all settings except RHCs. Only 14 (7.4%) TMed visits resulted in an antibiotic prescription. There were no differences in antibiotic prescribing rates by provider type. Diagnoses varied significantly between periods in all clinic types except the ED, with noninfectious diagnoses being higher in P2 vs P1 (Figure 1). Providers felt that COVID-19 led to fewer but sicker patients presenting for care, and variable impact on antibiotic prescribing (Figure 2). Table. Percent of Encounters with an Antibiotic by Clinic Type, Pre- and Post-COVID-19 Figure 1. Diagnosis Rates by Clinic Type, Pre- and Post-COVID-19 Figure 2. Themes from Provider Interviews about perceived Impact of COVID-19 on Clinician Practice Conclusion The proportion of encounters with non-infectious diagnoses increased and antibiotic prescribing rates decreased significantly in all pediatric ambulatory settings post-COVID-19 except RHCs. Almost all TMed encounters occurred in the primary care setting, and few resulted in an antibiotic prescription. Providers felt they saw fewer patients and higher acuity of illness post COVID-19. Disclosures Hillary Spencer, MD, MPH, NIH (T32 grant support) (Grant/Research Support)

scholarly journals Implementation of C-reactive protein point of care testing to improve antibiotic targeting in respiratory illness in Vietnamese primary care (ICAT): a study protocol for a cluster randomised controlled trial

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e040977
Author(s):  
Nga Thi Thuy Do ◽  
Rachel Claire Greer ◽  
Yoel Lubell ◽  
Sabine Dittrich ◽  
Maida Vandendorpe ◽  
...  
Keyword(s):  
Primary Care ◽  
Antibiotic Prescription ◽  
Point Of Care ◽  
Controlled Trial ◽  
Cluster Randomised Controlled Trial ◽  
Antibiotic Use ◽  
Routine Care ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Randomised Controlled

IntroductionC-reactive protein (CRP), a biomarker of infection, has been used widely in high-income settings to guide antibiotic treatment in patients presenting with respiratory illnesses in primary care. Recent trials in low- and middle-income countries showed that CRP testing could safely reduce antibiotic use in patients with non-severe acute respiratory infections (ARIs) and fever in primary care. The studies, however, were conducted in a research-oriented context, with research staff closely monitoring healthcare behaviour thus potentially influencing healthcare workers’ prescribing practices. For policy-makers to consider wide-scale roll-out, a pragmatic implementation study of the impact of CRP point of care (POC) testing in routine care is needed.Methods and analysisA pragmatic, cluster-randomised controlled trial, with two study arms, consisting of 24 commune health centres (CHC) in the intervention arm (provision of CRP tests with additional healthcare worker guidance) and 24 facilities acting as controls (routine care). Comparison between the treatment arms will be through logistic regression, with the treatment assignment as a fixed effect, and the CHC as a random effect. With 48 clusters, an average of 10 consultations per facility per week will result in approximately 520 over 1 year, and 24 960 in total (12 480 per arm). We will be able to detect a reduction of 12% to 23% or more in immediate antibiotic prescription as a result of the CRP POC intervention. The primary endpoint is the proportion of patient consultations for ARI resulting in immediate antibiotic prescription. Secondary endpoints include the proportion of all patients receiving an antibiotic prescription regardless of ARI diagnosis, frequency of re-consultation, subsequent antibiotic use when antibiotics are not prescribed, referral and hospitalisation.Ethics and disseminationThe study protocol was approved by the Oxford University Tropical Research Ethics Committee (OxTREC, Reference: 53–18), and the ethical committee of the National Hospital for Tropical Diseases in Vietnam (Reference:07/HDDD-NDTW/2019). Results from this study will be disseminated via meetings with stakeholders, conferences and publications in peer-reviewed journals. Authorship and reporting of this work will follow international guidelines.Trial registration detailsNCT03855215; Pre-results.

scholarly journals Optimizing Antibiotic Prescribing for Acute Respiratory Tract Infection in German Primary Care: Study Protocol for Evaluation of the RESIST Program (Preprint)

2020 ◽  
Author(s):  
Christin Löffler ◽  
Antje Krüger ◽  
Anne Daubmann ◽  
Julia Iwen ◽  
Marc Biedermann ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Tract Infection ◽  
Statutory Health Insurance ◽  
Antibiotic Prescription ◽  
Acute Respiratory Tract Infection ◽  
Control Group ◽  
Antibiotic Prescribing ◽  
Prescription Rate ◽  
Before And After

BACKGROUND The emergence and increased spread of microbial resistance is a major challenge to all health care systems worldwide. In primary care, acute respiratory tract infection (ARTI) is the health condition most strongly related to antibiotic overuse. OBJECTIVE The RESIST program aims at optimizing antibiotic prescribing for ARTI in German primary care. By completing a problem-orientated online training course, physicians are motivated and empowered to utilize patient-centered doctor-patient communication strategies, including shared decision making, in the treatment of patients with ARTI. METHODS RESIST will be evaluated in the form of a nonrandomized controlled trial. Approximately 3000 physicians of 8 (out of 16) German federal states can participate in the program. Patient and physician data are retrieved from routine health care data. Physicians not participating in the program serve as controls, either among the 8 participating regional Associations of Statutory Health Insurance Physicians (control group 1) or among the remaining associations not participating in RESIST (control group 2). Antibiotic prescription rates before the intervention (T0: 2016, 1st and 2nd quarters of 2017) and after the intervention (T1: 3rd quarter of 2017 until 1st quarter of 2019) will be compared. The primary outcome measure is the overall antibiotic prescription rate for all patients insured with German statutory health insurance before and after provision of the online course. The secondary outcome is the antibiotic prescription rate for coded ARTI before and after the intervention. RESULTS RESIST is publicly funded by the Innovations funds of the Federal Joint Committee in Germany and was approved in December 2016. Recruitment of physicians is now completed, and a total of 2460 physicians participated in the intervention. Data analysis started in February 2020. CONCLUSIONS With approximately 3000 physicians participating in the program, RESIST is among the largest real-world interventions aiming at reducing inadequate antibiotic prescribing for ARTI in primary care. Long-term follow up of up to 21 months will allow for investigating the sustainability of the intervention. CLINICALTRIAL ISRCTN Registry ISRCTN13934505; http://www.isrctn.com/ISRCTN13934505 INTERNATIONAL REGISTERED REPORT RR1-10.2196/18648

scholarly journals Knowledge, Attitudes, and Reported Practices Among Obstetrician-Gynecologists in the USA Regarding Antibiotic Prescribing for Upper Respiratory Tract Infections

2005 ◽  
Vol 13 (1) ◽  
pp. 17-24 ◽  
Author(s):  
Shadi Chamany ◽  
Jay Schulkin ◽  
Charles E. Rose ◽  
Laura E. Riley ◽  
Richard E. Besser
Keyword(s):  
Primary Care ◽  
Respiratory Tract Infections ◽  
Antibiotic Use ◽  
Upper Respiratory Tract Infections ◽  
Antibiotic Prescribing ◽  
Upper Respiratory Tract ◽  
Office Visits ◽  
The Common ◽  
Upper Respiratory ◽  
Tract Infections

Background:Knowledge, attitudes, and practices regarding antibiotic prescribing for upper respiratory tract infections (URIs) have not been well described among obstetrician-gynecologists (OB/GYNs). This information is useful for determining whether an OB/GYN-specific program promoting appropriate antibiotic use would significantly contribute to the efforts to decrease inappropriate antibiotic use among primary care providers.Methods:An anonymous questionnaire asking about the treatment of URIs was sent to 1031 obstetrician-gynecologists.Results:The overall response rate was 46%. The majority of respondents (92%) were aware of the relationship between antibiotic use and antibiotic resistance, and respondents estimated that 5% of their patients had URI symptoms at their office visits. Overall, 56% of respondents reported that they would prescribe an antibiotic for uncomplicated bronchitis and 43% for the common cold. OB/GYNs with the fewest years of experience were less likely than those with the most years of experience to report prescribing for uncomplicated bronchitis (Odds ratio (OR) 0.46, 95% confidence interval (CI) 0.23 to 0.91) or the common cold (OR 0.44, CI 0.22 to 0.89). The majority of respondents (60%) believed that most patients wanted an antibiotic for URI symptoms, with male OB/GYNs being more likely than female OB/GYNs (OR 2.1, CI 1.2 to 3.8) to hold this belief. Both male OB/GYNs (OR 1.9, CI 1.1 to 3.4) and rural practitioners (OR 2.1, CI 1.1 to 4.0) were more likely to believe that it was hard to withhold antibiotics for URI symptoms because other physicians prescribe antibiotics for these symptoms. OB/GYNs who believed that postgraduate training prepared them well for primary care management were more likely than those who did not (OR 2.1, CI 1.1 to 4.2) to believe that they could reduce antibiotic prescribing without reducing patient satisfaction.Conclusion:Multiple demographic factors affect attitudes and reported practices regarding antibiotic prescribing. However, in view of the low proportion of office visits for URIs, an OB/GYN-specific program is not warranted.

scholarly journals Outpatient Antibiotic Use for Common Infectious Diagnoses: Patterns in Telehealth During the Emergence of COVID-19

2021 ◽  
Vol 1 (S1) ◽  
pp. s35-s36
Author(s):  
Brigid Wilson ◽  
Taissa Bej ◽  
Sunah Song ◽  
Janet M Briggs ◽  
Richard Banks ◽  
...  
Keyword(s):  
Primary Care ◽  
Healthcare System ◽  
Acute Respiratory Infection ◽  
Antibiotic Prescription ◽  
Antibiotic Use ◽  
Outpatient Clinics ◽  
Administrative Databases ◽  
Community Based ◽  
Outpatient Visits ◽  
Outpatient Settings

Background: The influence of increased use of telehealth during the emergence of COVID-19 on antibiotic prescriptions in outpatient settings is unknown. The VA Northeast Ohio Healthcare System has 13 community-based outpatient clinics (CBOCs) that provide primary and preventive care. We assessed changes in antibiotic prescriptions that occurred as care shifted from in-person to telehealth visits. Methods: Using VHA administrative databases, we identified all primary care CBOC visits between January 1, 2019, and December 31, 2020, that included a diagnosis for an acute respiratory infection (ARI), a urinary tract infection (UTI), or a skin or soft-tissue infection (SSTI), excluding visits with >1 of these diagnoses or with additional infectious diagnoses (eg, pneumonia, influenza). We summarized the proportion of telehealth visits and the proportion of patients prescribed antibiotics at quarterly intervals. We specifically assessed outpatient visits from April to December 2019 compared to the same months in 2020 to account for seasonality while analyzing diagnosis and antibiotic trends in the emergence of the COVID-19 pandemic. Results: The patients receiving care in April–December 2019 compared to April–December 2020 were similar (Table 1). From April through December 2019, 90% of CBOC primary care visits with a diagnosis for ARI, UTI, or SSTI were in-person, and antibiotics were prescribed at 63%, 46%, and 65% of visits in either modality, respectively (Figure 1). From April through December 2020, only 33% of CBOC primary care visits for ARI, UTI, and SSTI were in person, and antibiotics were prescribed at 46%, 38%, and 47% of visits in either modality, respectively. Comparing April–December in 2019 and 2020, the number of CBOC visits for ARI fell by 76% (2,152 visits to 509 visits), with a more modest decline of 20% and 35% observed for UTI and SSTI visits. In-person visits for ARIs and SSTIs were more likely than telehealth visits to result in an antibiotic prescription (Figure 2). Conclusions: Among the CBOCs at our healthcare system, an increase in the proportion of telehealth visits and a reduction in ARI diagnoses occurred after the emergence of COVID-19. In this setting, we observed a reduction in the proportion of visits for ARIs, UTIs, and SSTIs that included an antibiotic prescription.Funding: MerckDisclosures: None

scholarly journals Perceptions, Current Practices and Interventions of Community Pharmacists Regarding Antimicrobial Stewardship: A Qualitative Study in France

2021 ◽  
Author(s):  
Claire Durand ◽  
Aude Chappuis ◽  
Eric Douriez ◽  
Frédérique Poulain ◽  
Raheelah Ahmad ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Antimicrobial Resistance ◽  
Community Health ◽  
Antimicrobial Stewardship ◽  
Thematic Analysis ◽  
Community Pharmacists ◽  
Antibiotic Use ◽  
Antibiotic Prescribing ◽  
Community Health Care

Abstract Background: Community health care accounts for the vast majority of antibiotic use in Europe. Given the threat of antimicrobial resistance (AMR), there is an urgent need to develop new antimicrobial stewardship (AMS) interventions in primary care that could involve different health care providers including community pharmacists. This study aimed to explore the perceptions, currents practices and interventions of community pharmacists regarding antimicrobial stewardship.Methods: Semi-structured qualitative interviews were conducted with community pharmacists in France. Participants were recruited through a professional organization of community pharmacists combined with a snowballing technique. Interviews were audio recorded, transcribed and analyzed using thematic analysis. The Consolidated Framework for Implementation Research was used while developing the interview guide and carrying out thematic analysis.Results: Sixteen community pharmacists participated. All the respondents had good awareness about antimicrobial resistance and believed community pharmacists had an important role in tackling AMR. Some barriers to community pharmacists’ participation in AMS were identified such as difficult interactions with prescribers, lack of time and lack of access to patient medical records and diagnosis. Increased patient education, audits and feedback of antibiotic prescribing, increased point-of-care testing and delayed prescribing were interventions suggested by the pharmacists to improve antibiotic use in primary care. Strategies cited by participants to facilitate the implementation of such interventions are increased pharmacist-general practitioner collaboration, specialized training, clinical decision support tools as well as financial incentives. Conclusions: This study suggests that community pharmacists could play a greater role in infection management and AMS interventions. Further interprofessional collaboration is needed to optimize antibiotic prescribing and utilization in community health care.

scholarly journals Understanding the gender gap in antibiotic prescribing: a cross-sectional analysis of English primary care

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e020203 ◽  
Author(s):  
David R M Smith ◽  
F Christiaan K Dolk ◽  
Timo Smieszek ◽  
Julie V Robotham ◽  
Koen B Pouwels
Keyword(s):  
Primary Care ◽  
Tract Infection ◽  
Gender Gap ◽  
Antibiotic Prescription ◽  
The Elderly ◽  
Antibiotic Prescribing ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Sectional Analysis ◽  
To Receive

ObjectivesTo explore the causes of the gender gap in antibiotic prescribing, and to determine whether women are more likely than men to receive an antibiotic prescription per consultation.DesignCross-sectional analysis of routinely collected electronic medical records from The Health Improvement Network (THIN).SettingEnglish primary care.ParticipantsPatients who consulted general practices registered with THIN between 2013 and 2015.Primary and secondary outcome measuresTotal antibiotic prescribing was measured in children (<19 years), adults (19–64 years) and the elderly (65+ years). For 12 common conditions, the number of adult consultations was measured, and the relative risk (RR) of being prescribed antibiotics when consulting as female or with comorbidity was estimated.ResultsAmong 4.57 million antibiotic prescriptions observed in the data, female patients received 67% more prescriptions than male patients, and 43% more when excluding antibiotics used to treat urinary tract infection (UTI). These gaps were more pronounced in adult women (99% more prescriptions than men; 69% more when excluding UTI) than in children (9%; 0%) or the elderly (67%; 38%). Among adults, women accounted for 64% of consultations (62% among patients with comorbidity), but were not substantially more likely than men to receive an antibiotic prescription when consulting with common conditions such as cough (RR 1.01; 95% CI 1.00 to 1.02), sore throat (RR 1.01, 95% CI 1.00 to 1.01) and lower respiratory tract infection (RR 1.00, 95% CI 1.00 to 1.01). Exceptions were skin conditions: women were less likely to be prescribed antibiotics when consulting with acne (RR 0.67, 95% CI 0.66 to 0.69) or impetigo (RR 0.85, 95% CI 0.81 to 0.88).ConclusionsThe gender gap in antibiotic prescribing can largely be explained by consultation behaviour. Although in most cases adult men and women are equally likely to be prescribed an antibiotic when consulting primary care, it is unclear whether or not they are equally indicated for antibiotic therapy.

scholarly journals 264Antibiotic use associated with acute gastroenteritis in Australian primary care

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Wen-Qiang He ◽  
Martyn Kirk ◽  
John Hall ◽  
Bette Liu
Keyword(s):  
Primary Care ◽  
Acute Gastroenteritis ◽  
Treatment Guidelines ◽  
Antibiotic Use ◽  
Health Concern ◽  
Antibiotic Prescribing ◽  
Remote Areas ◽  
Antibiotics Use ◽  
Education And Awareness ◽  
Campylobacter Infections

Abstract Background Inappropriate antibiotic use is a global health concern as it increases antibiotic resistance. Antibiotics are not routinely recommended for treating acute gastroenteritis, non-typhoidal salmonella and campylobacter infections. We investigated adherence to these recommendations in primary care. Methods We used a large electronic database of primary care records to identify presentations for acute gastroenteritis, non-typhoidal salmonella and campylobacter infections and antibiotic prescribing from 1st Jan 2013 to 31 December 2018. We estimated the proportions of cases prescribed antibiotics according to various characteristics and examined the antibiotics prescribed. Results A total of 86998, 1106, and 1952 participants were identified with acute gastroenteritis, non-typhoidal salmonella, and campylobacter infections and correspondingly 10% (8720/86998), 40% (437/1106), and 57% (1118/1952) of these cases were prescribed antibiotics in the period up to 5 days post-diagnosis. Patients residing in outer regional/remote areas and those from Northern Territory and Queensland were more likely to be prescribed antibiotics than those residing in major cities and those from other states (p &lt; =0.04). No dominant antibiotic class was prescribed for acute gastroenteritis. Quinolones (28.6%) and macrolides (27.0%) were the most frequently prescribed antibiotics for non-typhoidal salmonella, and macrolides (69%) were the predominant antibiotics prescribed for campylobacter. Conclusion The high proportion of antibiotics dispensed in the general population with acute gastroenteritis, non-typhoidal salmonella and campylobacter infections suggests that antimicrobial stewardship needs to include better education and awareness around treatment guidelines for such infections. Key messages Antibiotics use was common for Australian population with acute gastroenteritis, particularly those with non-typhoidal salmonella and campylobacter infections.

Sign in / Sign up

Export Citation Format

Share Document