Pattern and appropriateness of antibiotic prescriptions for upper respiratory tract infections in primary care paediatric patients

Bianco, Aida; Licata, Francesca; Nobile, Carmelo Ga; Napolitano, Francesco; Pavia, Marco

doi:10.1016/j.ijantimicag.2021.106469

Cited by 14 publications

(6 citation statements)

References 29 publications

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“…The high rate of carbapenem resistance (>80%) and MDR among Acinetobacter baumannii could also be linked to the inappropriate use of antibiotics, as previously reported [31]. In the authors' opinion, it is critical to avoid the use of antibiotics in all the conditions where they are not recommended [32][33][34][35][36].…”

Section: Discussionmentioning

confidence: 55%

Prevalence of Colonization with Multidrug-Resistant Bacteria: Results of a 5-Year Active Surveillance in Patients Attending a Teaching Hospital

Quirino,

Cicino,

Scarlata

et al. 2023

Antibiotics

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Combating antimicrobial resistance (AMR) requires comprehensive efforts, such as screening to identify patients colonized by multidrug-resistant microorganisms (MDROs). The primary purpose of this study was to estimate the AMR pattern of methicillin-resistant Staphylococcus aureus (MRSA) isolated from nasal surveillance swabs and MDROs isolated from pharyngeal and rectal surveillance swabs in patients attending a teaching hospital. Data were sought retrospectively, from 1 January 2017 to 31 December 2021, from the records produced by the hospital microbiology laboratory. Duplicate isolates, defined as additional isolates of the same microorganism with identical antibiograms, were excluded. Among Staphylococcus aureus isolates from nasal swabs, 18.2% were oxacillin-resistant. Among Gram-negative bacteria, 39.8% of Klebsiella pneumoniae and 83.5% of Acinetobacter baumannii isolates were carbapenem-resistant. Resistance to three antibiotic categories was high among Acinetobacter baumannii (85.8%) and Klebsiella pneumoniae (42.4%). The present data highlight a high prevalence of MDRO colonization among patients admitted to the hospital and suggest that screening for MDROs could be an important tool for infection control purposes, especially in geographical areas where limiting the spread of MDROs is crucial. The results also underline the importance of active surveillance, especially for carbapenem-resistant, Gram-negative bacteria in reducing their transmission, especially in high-risk units.

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Section: Discussionmentioning

confidence: 55%

Prevalence of Colonization with Multidrug-Resistant Bacteria: Results of a 5-Year Active Surveillance in Patients Attending a Teaching Hospital

Quirino,

Cicino,

Scarlata

et al. 2023

Antibiotics

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“…As is known, vaccine hesitancy played an important role in COVID, even more than what is expected for other type of pathogens; such behavior impacts on disease spread and consequent drug prescription attitudes on the territory, and this all has a foreseeable impact on hospital demand [66][67][68]. In particular, antibiotic over prescription (by all types of health personnel) is constantly been linked with the occurrence of antimicrobial resistance, and thus with more difficulties in patient care management and further hospitalization increase [69][70][71][72].…”

Section: Plos Onementioning

confidence: 99%

Burden of delayed discharge on acute hospital medical wards: A retrospective ecological study in Rome, Italy

Vinci,

Furia,

Cammalleri

et al. 2024

PLoS ONE

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Introduction Delayed discharge represents the difficulty in proceeding with discharge of patients who do not have any further benefit from prolonged stay. A quota of this problem is related to organizational issues. In the Lazio region in Italy, a macro service re-organization in on the way, with a network of hospital and territorial centers engaged in structuring in- and out- of hospital patient pathways, with a special focus on intermediate care structures. Purpose of this study is to quantify the burden of delayed discharge on a single hospital structure, in order to estimate costs and occurrence of potential resource misplacement. Material and methods Observational Retrospective study conducted at the Santo Spirito Hospital in Rome, Italy. Observation period ranged from 1/09/2022, when the local database was instituted, to 1/03/2023 (6 months). Data from admissions records was anonymously collected. Data linkage with administrative local hospital database was performed in order to identify the date a discharge request was fired for each admission. Surgical discharges and Intensive Care Unit (ICU) discharges were excluded from this study. A Poisson hierarchical regression model was employed to investigate for the role of ward, Severity of Disease (SoD) and Risk of Mortality (RoM) on elongation of discharge time. Results 1222 medical ward admissions were recorded in the timeframe. 16% of them were considered as subject to potentially elongated stay, and a mean Delay in discharge of 6.3 days (SD 7.9) was observed. Discussion and conclusions Delayed discharge may cause a “bottleneck” in admissions and result in overcrowded Emergency Department, overall poor performance, and increase in overall costs. A consisted proportion of available beds can get inappropriately occupied, and this inflates both direct and indirect costs. Clinical conditions on admission are not a good predictor of delay in discharge, and the root causes of this phenomenon likely lie in organizational issues (on structure\system level) and social issues (on patient’s level).

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“…Physicians also need to reduce irrational antibiotic prescriptions to help change the public's misconception of the effectiveness of antibiotics for URTIs. Previous studies showed that nonevidence-based antibiotic prescriptions was frequent at the primary care level (88,90). It is important to implement and reinforce the clinical guidelines for the rational use of antibiotics in clinical practice (91).…”

Section: Policy and Practice Implicationsmentioning

confidence: 99%

The public’s antibiotic use behavioural patterns and their determinants for upper respiratory tract infections: a latent class analysis based on consumer behaviour model in China

Lin,

Duan,

Liu

et al. 2023

Front. Public Health

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BackgroundThe irrational use of antibiotics among the public is a major contributor to antimicrobial resistance (AMR), which is a serious global threat. Prior studies have demonstrated that there are different behavioural patterns regarding antibiotic use among the public, and targeted interventions for subgroups with different behavioural patterns may be more effective. Thus, this study aimed to identify the public’s behavioural patterns of antibiotic use for upper respiratory tract infections (URTIs) and their influencing factors.MethodsA cross-sectional survey was conducted among the general population in Chongqing, China. Consumer decision-making (Consumer Behaviour Model, CBM) was used to assess the public’s behaviours regarding antibiotic use, including need recognition, information searching, alternative evaluation, obtaining antibiotics, antibiotic consumption, and postuse evaluation. Furthermore, a latent class analysis was used to identify the underlying behavioural patterns among the public. The identified behavioural patterns of antibiotic use were further linked with individuals’ capacity, opportunity, and motivation factors of antibiotic use based on a multinominal logistic regression to explore possible determinants.ResultsA total of 815 respondents were enrolled in the study. The public’s irrational use of antibiotics was prevalent, including antibiotic self-medication (39.63%), nonprescription antibiotic purchasing (59.02%), and early stopping of antibiotic prescriptions (76.56%). Participants had inadequate knowledge of antibiotics (Mean = 2.33, SD = 1.71), reported high availability to antibiotics (Mean = 7.13, SD = 2.41), held strong belief in antibiotic effectiveness (Mean = 10.29, SD = 2.71), and demonstrated a high perceived threat of AMR (Mean = 12.30, SD = 3.20). Four behavioural patterns regarding antibiotic use for URTIs were identified, namely, “antibiotic self-medicators” (n = 165, 20.25%), “formal health care seekers” (n = 216, 26.50%), “various treatment users” (n = 198, 24.20%), and “self-medication without antibiotics” (n = 236, 28.96%). Individuals’ self-efficacy of antibiotic use, belief in antibiotic effectiveness, awareness of antibiotic side effects, perceived antibiotic availability, social influence, and demographics (age, education, medical insurance, and having a medical background) were significantly associated with the public’s different behavioural patterns of antibiotic use for URTIs.ConclusionThis study calls for collaborative efforts among the public, physicians, policy makers, and the implementation of precise and multifaceted interventions to effectively reduce irrational use of antibiotics in the public. Such interventions include identifying subgroups within the public to provide more targeted education about antibiotics and the management of URTIs, reinforcing the regulation of antibiotic dispensing, and improving physicians’ rational antibiotic prescriptions.

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Pattern and appropriateness of antibiotic prescriptions for upper respiratory tract infections in primary care paediatric patients

Cited by 14 publications

References 29 publications

Prevalence of Colonization with Multidrug-Resistant Bacteria: Results of a 5-Year Active Surveillance in Patients Attending a Teaching Hospital

Prevalence of Colonization with Multidrug-Resistant Bacteria: Results of a 5-Year Active Surveillance in Patients Attending a Teaching Hospital

Burden of delayed discharge on acute hospital medical wards: A retrospective ecological study in Rome, Italy

The public’s antibiotic use behavioural patterns and their determinants for upper respiratory tract infections: a latent class analysis based on consumer behaviour model in China

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