Inappropriate prescribing of antibiotics to patients with acute bronchitis

Abstract

Background/Aim. Inappropriate prescribing of antibiotics to the patients with acute bronchitis is frequent event in clinical practice with potentially serious consequences, although majority of treatment guidelines do not recommend it. The aim of this study was to reveal risk factors associated with inappropriate prescribing of antibiotics to the patients with acute bronchitis in primary healthcare. Methods. This case/control study included the adult patients with acute bronchitis during the initial encounter with a general practitioner. Prescription of an antibiotic was an event that defined the case, and patients without prescribed antibiotic served as controls. Results. Antibiotics (mostly macrolides and beta-lactams) were prescribed to the majority of patients with diagnosis of acute bronchitis (78.5%). A significant association was found between antibiotic prescription rates and patient age, whether an attending physician is a specialist or not and the average number of patients a physician sees per day [ORadjustedwas 1.029 (1.007-1.052), 0.347 (0.147-0.818) and 0.957 (0.923-0.992), respectively]. Conclusion. When there is primary care encounter with patients suffering from acute bronchitis, older patients are more likely to receive inappropriate antibiotic prescription, especially if their physician is without specialist training and has less patient encounters in his/her office daily.

Increase and Change in the Pattern of Antibiotic Use in Serbia (2010–2019)

“…The Watch-group antibiotics have a higher resistance potential when compared to the Access-group antibiotics [ 27 ], where azithromycin, with a proportion of around 10% of all antibiotics, stood out as the most used Watch-group antibiotic in Serbia in 2019. There are limited data about the antibiotic prescribing habits of physicians in Serbia, but a recent paper identified the over-prescription of antibiotics (mostly macrolides and beta-lactams) by physicians, as these agents were prescribed to the majority of patients with a diagnosis of acute bronchitis (78.5%), in contrast to the recommendations in the national guidelines [ 28 ]. However, penicillins (J01C) were the most frequently used group of antibiotics in Serbia, with a proportion of 32.9–39.3% in the 2010–2019 period, which is consistent with the results of studies conducted in European countries and the United States [ 16 , 29 , 30 ].…”

Composition and antimicrobial activity of essential oils of Salvia fruticosa and Salvia ringens (Lamiaceae)

“…Excessive and inappropriate use of antibiotics in the treatment of various infectious diseases has led to the resistance of many pathogens, which is a global problem in healthcare practice today, recorded also in Serbia 1 . In order to find new antimicrobial agents that would help to decrease the use of antibiotics, research into traditionally used medicinal plants and herbal products as well as related species of known medicinal plants has been intensified.…”

Immediate and long-term effects of COVID-19 on antibiotic dispensing: increasing use of Watch antibiotics

“…On the other hand, the proportion of azithromycin use in Serbia in 2019 was around 10% of all antibiotics [6]. In a recent study in Serbia, over-prescribing of antibiotics (mostly macrolides and beta-lactams) by physicians for a diagnosis of acute bronchitis (78.5%) was shown, which is not aligned with the recommendations in the guidelines for appropriate antibiotic use [23]. The fall in the dispensing of most antibiotics, including amoxicillin during the COVID-19 period, suggests a potential decrease in the occurrence of respiratory tract infections as a result of social distancing and other protective measures implemented during the COVID 19 period.…”