Prevalence of Antibiotic Prescription in Patients with Acute Rhinosinusitis Treated by General Practitioners and Otolaryngologists in Germany—A Retrospective Cohort Study

Abstract

(1) Background: The goal of this retrospective cohort study, based on real-world data and conducted in Germany, was to investigate the prevalence of antibiotic (AB) prescription in patients with acute rhinosinusitis (ARS). (2) Methods: Data from the Disease Analyzer database were used for this cross-sectional study. Patients aged ≥18 years diagnosed with acute sinusitis by general practitioners (GPs) and ear, nose, throat (ENT) specialists between January 2012 and December 2020 were included. The main outcome of the study was the proportion of patients with ARS who received an AB prescription on the day of diagnosis or within three days afterwards. The proportion was estimated separately for patients treated by GPs and ENTs, and also for five age groups, as well as women and men. (3) Results: In total, 308,095 patients were diagnosed with ARS (187,838 by GPs and 120,257 by ENTs). 50.9% of patients treated by GPs and 50.0% treated by ENTs received an AB prescription. AB prevalence increased with age from 46.9% in the age group 18–30 years to 55.5% in the age group > 60 years. (4) Conclusions: We have shown a high prevalence of potentially inappropriate AB prescription for adult patients with ARS in both GP and ENT practices and also among both women and men and in several age groups. There is an urgent need for interventions to reduce inappropriate AB use.

Efficacy of mucolytics and steam therapy in the management of sinusitis among Indians

“…Initially, several controversies existed regarding the origin of rhinosinusitis - whether it is bacterial or viral, however, studies have proved that it is commonly viral in origin that develops into bacterial rhino sinusitis [ 20 ] . The symptoms of acute rhinosinusitis peak between 3-4th day and gradually alleviates within 11-14 days [ 21 ]. It is associated with nasal discharge that is mucopurulent in nature corresponding to the neutrophil inflammatory infiltrate that does not necessarily represent infection from bacteria.…”

Efficacy and Effectiveness of the Herbal Medicinal Product BNO 1016 in the Management of Acute Rhinosinusitis in the Context of Antibiotic Stewardship

“…Acute bacterial rhinosinusitis is rare, with an incidence of 0.5-2% of viral ARS in adults and 5-10% in children [1,21]. Nevertheless, the prevalence of antibiotic prescription for ARS was found to be around 50% in Germany without any clinically relevant difference between patients attending GPs and those treated by ENT specialists [22]. Studies from Spain [3], the United Kingdom [23], Canada [24], and the USA [25] show a similar picture, with even higher trends (62% -82%) for potentially inappropriate antibiotic prescriptions.…”

“…In Canada, over 60% of patients received antibiotics for ARS, although only 18% of patients were in need of an antibiotic therapy [24]. Often, there is no difference in the proportion of antibiotic prescription between patients who meet the criteria for the prescription of an antibiotic and those who do not [22]. In a chart review study from the US, 92% of patients who did not fulfil the criteria for acute bacterial sinusitis (e.g., fever >38°C, double sickening) received antibiotics [26].…”

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

“…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].…”