Antibiotic utilization for adult acute respiratory tract infections in United States Emergency Departments

Schroeder, Anastasia M.; Lewis, Sarah S.; Sahmoun, Abe E.; Beal, James

doi:10.1016/j.ajem.2021.03.018

Cited by 5 publications

(4 citation statements)

References 8 publications

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“…In addition, this study investigated the association between patient characteristics and antibiotic utilization, which may help inform targeted outpatient antibiotic stewardship efforts. We observed that older adults ≥50 years of age had 27–40% higher odds of antibiotic treatment compared with younger adults, which aligns with prior studies of patients treated for respiratory tract infections in the emergency department setting [ 26 , 27 ]. In addition, patients located outside of the northeastern United States had 34–63% higher odds of antibiotic utilization compared with patients in the Northeast.…”

Section: Discussionsupporting

confidence: 88%

Outpatient Antibiotic and Antiviral Utilization Patterns in Patients Tested for Respiratory Pathogens in the United States: A Real-World Database Study

et al. 2022

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This retrospective observational study evaluated outpatient treatment patterns among patients with molecular-based viral diagnostic testing for suspected upper respiratory tract infections in the United States. Patients with a respiratory viral test were identified from 1 August 2016 to 1 July 2019 in a large national reference laboratory database linked to IQVIA’s prescription and medical claims databases. Antibiotic and influenza antiviral treatment patterns were reported up to 7 days post-test result. Predictors of antibiotic utilization were assessed using multivariable logistic regression. Among 9561 patients included in the study, 24.6% had evidence of ≥1 filled antibiotic prescription. Antibiotic utilization was higher in patients who tested negative for all viral targets (odds ratio [OR], 1.33; 95% confidence interval [CI], 1.17–1.50) and patients positive for non-influenza viruses (OR, 1.28; 95% CI, 1.09–1.51) compared with those influenza-positive only. Age ≥ 50 years and location outside of the northeast United States also predicted antibiotic utilization. Influenza antivirals were more common in influenza-positive patients compared with patients with other test results (32.5% vs. 3.6–9.0%). Thus, in this real-world study, antibiotic utilization was elevated in patients positive for non-influenza viruses, although antibiotics would generally not be indicated. Further research on pairing diagnostic tools with outpatient antibiotic stewardship programs is needed.

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Section: Discussionsupporting

confidence: 88%

Outpatient Antibiotic and Antiviral Utilization Patterns in Patients Tested for Respiratory Pathogens in the United States: A Real-World Database Study

et al. 2022

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“…Recent epidemiological data suggest an increased incidence of invasive Fusobacterium spp infections from 2010 to 2017 5. This trend might be explained by several factors: a decrease in antibiotic prescriptions for upper airway tract infections, more sensitive laboratory techniques for pathogen detection and decreased rates of tonsillectomy 26 27…”

Section: Discussionmentioning

confidence: 99%

“… 5 This trend might be explained by several factors: a decrease in antibiotic prescriptions for upper airway tract infections, more sensitive laboratory techniques for pathogen detection and decreased rates of tonsillectomy. 26 27 …”

Section: Discussionmentioning

confidence: 99%

Complex Lemierre syndrome with multisystemic abscesses

et al. 2023

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We present here the challenging case of severe Lemierre syndrome in a healthy woman in her late twenties, whose clinical presentation was characterised by lung abscesses and disseminated systemic abscesses in the brain, the abdomen and the soft-tissues, as a likely consequence of a patent foramen ovale. Blood cultures were positive forFusobacterium necrophorumand a right lingual vein thrombosis was detected at a late stage when the patient developed a septic shock. Initial antimicrobial therapy with metronidazole and ceftriaxone was modified to meropenem due to progressive worsening. The patient underwent laparoscopy and neurosurgical drainage of a cerebral abscess. She spent many days in the intensive care unit and recovered fully after 6 weeks on meropenem therapy. Although considered rare, the incidence of Lemierre syndrome, a potentially life-threatening condition, is increasing. The clinician should promptly recognise and treat it while being aware of its potential atypical presentations.

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“…Therefore, it could be attributed to insufficient knowledge about the risk factors for antibiotic resistance, or antibiotics prescribed by healthcare workers may not result in antibiotic resistance (Garba et al, 2018). Interestingly, a study conducted in the USA (Schroeder et al, 2021) showed a progressive reduction in the utilisation of antibiotics for acute respiratory tract infections. So, actions like educating doctors and patients about antibiotics and antimicrobial stewardship programs could help stop the overuse of antibiotics.…”

Section: Discussionmentioning

confidence: 99%

Knowledge, attitude, and practice on antibiotics use among healthcare workers: A cross-sectional study in Niger state, Nigeria

Abubakar

Sárváry

2023

Journal of Infection Prevention

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Introduction Antibiotic resistance is a public health concern in Nigeria and the world, and healthcare workers contributed to the upsurge of antibiotic resistance in hospital settings. This study focused on the knowledge, attitude, and practice (KAP) of antibiotic use and the frequency of prescriptions of antibiotics from the list of WHO Model Essentials Antibiotics (AWaRe) (in the last 6 months) among healthcare workers and established the determining factors in six hospitals in Niger state, Nigeria. Methodology A KAP survey was conducted in Niger State, Nigeria, from March to June 2022. A structured self-administered, pretested questionnaire was distributed to six hospitals in the state following a stratified random sampling considering the staff capacity, the population of the city, and patients’ patronage. Results A total of 350 questionnaires distributed, and 313 (89.4%) completed and returned from the six hospitals. The median scores were knowledge (75%), attitude (69%), practice (62%), and self-reported prescription (70%), and respondents with good scores were knowledge [195 (62.3%)], attitude [185 (59.1%)], practice [201 (64.2%)], and prescription [117 (37.4%)]. In multivariate analysis, older respondents are more likely to have a good prescription ( p = 0.006), and prior antimicrobial training improved their knowledge ( p < 0.001), attitude ( p = 0.007), and prescription pattern ( p = 0.009). All the study participants had prescribed one or more of the most prescribed antibiotics; Amoxicillin clavulanate (Access group, 96.5%), Amoxicillin (Access group, 95.9%), and Metronidazole (Access group, 95.7%). Conclusions The study suggests that antibiotic education for healthcare workers and antimicrobial stewardship programs are significant interventions to mitigate antibiotic overuse in the state.

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Antibiotic utilization for adult acute respiratory tract infections in United States Emergency Departments

Cited by 5 publications

References 8 publications

Outpatient Antibiotic and Antiviral Utilization Patterns in Patients Tested for Respiratory Pathogens in the United States: A Real-World Database Study

Outpatient Antibiotic and Antiviral Utilization Patterns in Patients Tested for Respiratory Pathogens in the United States: A Real-World Database Study

Complex Lemierre syndrome with multisystemic abscesses

Knowledge, attitude, and practice on antibiotics use among healthcare workers: A cross-sectional study in Niger state, Nigeria

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