Prevalence of and Factors Associated with Antibiotic Prescriptions in Patients with Acute Lower and Upper Respiratory Tract Infections—A Case-Control Study

Kern, Winfried V.; Kostev, Karel

doi:10.3390/antibiotics10040455

Cited by 13 publications

(9 citation statements)

References 30 publications

(31 reference statements)

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“…The Disease Analyzer database is composed of sociodemographic, diagnosis, and prescription data obtained from general and specialized practices in Germany. Although this database covers only approximately 3-4% of the private practices in Germany, it has previously been demonstrated to be representative and has been widely used for epidemiological studies in recent years [23][24][25].…”

Section: Methodsmentioning

confidence: 99%

The COVID-19 Pandemic Enhanced the Decade-Long Trend of the Decreasing Utilization of Antibiotics

Tanislav

Rosenbauer

Kostev³

2023

Antibiotics

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Purpose/Introduction: A decline in antibiotic (AB) prescriptions was reported during the coronavirus 2019 (COVID-19) pandemic. Therefore, we investigated AB utilization during the COVID-19 pandemic using data from a large database in Germany. Methods: AB prescriptions in the Disease Analyzer database (IQVIA) were analyzed for each year between 2011 and 2021. Descriptive statistics were used to assess developments in relation to age group, sex, and antibacterial substances. Infection incidence rates were also investigated. Results: In total, 1,165,642 patients received antibiotic prescriptions during the entire study period (mean age: 51.8; SD: 18.4 years; 55.3% females). AB prescriptions started to decline in 2015 (505 patients per practice), and this development persisted until 2021 (2020: 300 patients per practice and 2021: 266 patients per practice). The sharpest drop was observed in 2020 and occurred in both women and men (27.4% and 30.1%). In the youngest age group (≤30), the decrease was −56%, while in the age group >70, it was −38%. The number of patients with prescriptions for fluoroquinolones dropped the most, falling from 117 in 2015 to 35 in 2021 (−70%), followed by macrolides (−56%) and tetracyclines (−56%). In 2021, 46% fewer patients were diagnosed with acute lower respiratory infections, 19% fewer with chronic lower respiratory diseases, and just 10% fewer with diseases of the urinary system. Conclusion: AB prescriptions decreased more in the first year (2020) of the COVID-19 pandemic than infectious diseases did. While the factor of older age influenced this trend negatively, it remained unaffected by the factor of sex and the selected antibacterial substance.

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Section: Methodsmentioning

confidence: 99%

The COVID-19 Pandemic Enhanced the Decade-Long Trend of the Decreasing Utilization of Antibiotics

Tanislav

Rosenbauer

Kostev³

2023

Antibiotics

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“…It has previously been shown that the panel of practices included in the Disease Analyzer database is representative of general and specialized practices in Germany [ 16 ]. Finally, this database has already been used in previous studies focusing on antihypertensive therapy [ 17 , 18 ] as well as respiratory infections [ 19 , 20 ].…”

Section: Methodsmentioning

confidence: 99%

Association between Antihypertensive Therapy and Risk of Acute Lower Respiratory Infections (ALRI): A Retrospective Cohort Study

Heidemann¹,

Konrad²,

Roderburg³

et al. 2022

Healthcare

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Purpose: The aim of this study was to analyze the association between antihypertensive drugs and the incidence of acute lower respiratory infections in patients treated in general practices in Germany. Methods: After propensity score matching of five antihypertensive drug classes, a total of 377,470 patients aged ≥18 years were available for analysis. The association between each antihypertensive drug class and ALRI incidence as compared to all other antihypertensive drug classes (as a group) was studied using conditional Cox regression analyses. Because of multiple comparisons and large patient samples, findings were clinically considered relevant when the hazard ratio was <0.85 or >1.15. Results: The regression analyses applied found no clinically relevant associations between antihypertensive drugs and the incidence of acute lower respiratory infections, as all hazard ratios were between 0.85 and 1.15. Conclusion: In the present study, only slight and not clinically relevant increases or decreases in the ALRI incidence were observed. Additional studies are necessary to further explore the risks associated with antihypertensive agents that are widely embedded in today’s clinical practice.

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“…Although most RTIs are viral, nearly 70% of patients receive antibiotic therapy, which is unjustified as there is no evidence that its use will prevent bacterial superinfection. Such irrational therapy can even lead to harm as it contributes to increased antibiotic resistance and exposes patients to adverse effects (9)(10)(11) . Symptomatic treatment with antipyretic and analgesic agents, antitussives, expectorants, mucolytics and decongestants is recommended for viral infections.…”

Section: Treatment Guidelines For Respiratory Tract Infectionsmentioning

confidence: 99%

Rational phytotherapy as an alternative treatment for acute respiratory tract infections

Zwołińska¹

2022

Pediatr Med Rodz

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Acute respiratory tract infections in children are the most common reason for primary care appointments. Although the vast majority of cases are viral, antibiotic therapy, which involves more risks than benefits in these patients, is still overused, contributing to antibiotic resistance and adverse effects. Almost all recommendations indicate avoiding such approach and use symptomatic treatment supplemented with plant-based formulations instead. There is abundance of different medicinal plants that contain compounds with proven antiviral, antioxidant and immunomodulatory properties, which effectively support the combat against respiratory infections, especially if combined in one product (synergism). Contemporary rational phytotherapy assumes a scientific approach to plant-derived formulations, and it should be emphasised that the registration of herbal medicines is subject to the same restrictions as in the case of synthetic drugs. The paper discusses the composition and activity of compounds contained in medicinal plants and their role in the treatment of respiratory tract infections, with main focus on Pelargonium sidoides and elderberry, the properties of which have so far been the most thoroughly investigated and described. Their efficacy and safety in different forms of respiratory tract infections were discussed, showing that the use of products based on these plants significantly reduces disease duration and severity of clinical symptoms, as well as the need to use other agents, including antibiotics. The reasons for the use of Pelargonium sidoides preparations in the prevention and treatment of COVID-19 were also presented.

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Prevalence of and Factors Associated with Antibiotic Prescriptions in Patients with Acute Lower and Upper Respiratory Tract Infections—A Case-Control Study

Cited by 13 publications

References 30 publications

The COVID-19 Pandemic Enhanced the Decade-Long Trend of the Decreasing Utilization of Antibiotics

The COVID-19 Pandemic Enhanced the Decade-Long Trend of the Decreasing Utilization of Antibiotics

Association between Antihypertensive Therapy and Risk of Acute Lower Respiratory Infections (ALRI): A Retrospective Cohort Study

Rational phytotherapy as an alternative treatment for acute respiratory tract infections

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