Applicability of Outpatient Quality Indicators for Appropriate Antibiotic Use in a Primary Health Care Area: a Point Prevalence Survey

March-López, Pablo; Madridejos, Rosa; Tomàs, Rosa; Boix-Palop, Lucía; Arcenillas, Paula; Gómez, Lucía; Padilla, Emma; Xercavins, Mariona; Martínez, Laura; Massats, Úrsula; Badía, Cristina; Lledó, Joan Manuel Sánchez; Casino, Alberto Domingo; Nicolás, Jordi

doi:10.1128/aac.01266-20

Cited by 3 publications

(3 citation statements)

References 23 publications

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“…This has also been observed in other studies. 6 , 9 , 33 , 43 , 44 Utilization of diagnostics and clinical decision supports to help identify which patients are more likely to benefit from antibiotics should be explored. Public belief that antibiotics are necessary for bronchitis has been demonstrated 45 and should also be considered when developing strategies to reduce antibiotic prescribing, for example strengthening shared decision-making, which can influence antibiotic prescription rates.…”

Section: Discussionmentioning

confidence: 99%

Point prevalence audit surveys of respiratory tract infection consultations and antibiotic prescribing in primary care before and during the COVID-19 pandemic in Ireland

Shah

Fleming

Barbosa

et al. 2023

Journal of Antimicrobial Chemotherapy

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Background Respiratory tract infections (RTIs) are the most common reason for prescribing antibiotics in general practice. The COVID-19 pandemic has impacted on antibiotic prescribing and delivery of primary care in Ireland. Objectives To assess the quality of antibiotic prescribing, the impact of the COVID-19 pandemic and identify opportunities for antimicrobial stewardship (AMS) in Ireland. Methods Point prevalence audit surveys for RTI consultations were conducted as part of a European study at three time periods: January–February 2020, March–May 2020 and March–May 2021. Antibiotic prescribing was assessed and comparisons made between the three time periods. Results In total, 765 consultations were recorded, which were mainly face to face before the pandemic, but changed to predominantly remote consultations during the pandemic surveys in 2020 and 2021 (82% and 75%). Antibiotics were prescribed in 54% of RTI consultations before the pandemic. During pandemic surveys, this dropped to 23% in 2020 and 21% in 2021. There was a decrease in prescribing of Red (reserve) agents in 2021. Assessment against indication-specific quality indicators showed a high proportion of consultations for bronchitis and tonsillitis resulting in an antibiotic prescription (67% and 85%). Point-of-care testing (POCT) to aid diagnosis of RTIs were utilized in less than 1% of consultations. Conclusions During the COVID-19 pandemic, there was a reduction in antibiotic prescribing. Opportunities identified to support AMS in primary care in Ireland are targeted initiatives to reduce antibiotic prescribing for bronchitis and tonsillitis and introducing POCT to support appropriate antibiotic prescribing.

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Section: Discussionmentioning

confidence: 99%

Point prevalence audit surveys of respiratory tract infection consultations and antibiotic prescribing in primary care before and during the COVID-19 pandemic in Ireland

Shah

Fleming

Barbosa

et al. 2023

Journal of Antimicrobial Chemotherapy

View full text Add to dashboard Cite

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“…The heterogeneous nature of RNA genomes complicates the targeting of specific sequences on viral proteins [ 190 ]. Thus, development of precision antivirals that target the regions of a coronavirus that are less likely to viably mutate, must be especially emphasized [ 160 , 236 – 238 ].…”

Section: Discussionmentioning

confidence: 99%

Precision therapeutic targets for COVID-19

Krumm

Lloyd

Francis

et al. 2021

Virol J

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Beginning in late 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged as a novel pathogen that causes coronavirus disease 2019 (COVID-19). SARS-CoV-2 has infected more than 111 million people worldwide and caused over 2.47 million deaths. Individuals infected with SARS-CoV-2 show symptoms of fever, cough, dyspnea, and fatigue with severe cases that can develop into pneumonia, myocarditis, acute respiratory distress syndrome, hypercoagulability, and even multi-organ failure. Current clinical management consists largely of supportive care as commonly administered treatments, including convalescent plasma, remdesivir, and high-dose glucocorticoids. These have demonstrated modest benefits in a small subset of hospitalized patients, with only dexamethasone showing demonstrable efficacy in reducing mortality and length of hospitalization. At this time, no SARS-CoV-2-specific antiviral drugs are available, although several vaccines have been approved for use in recent months. In this review, we will evaluate the efficacy of preclinical and clinical drugs that precisely target three different, essential steps of the SARS-CoV-2 replication cycle: the spike protein during entry, main protease (MPro) during proteolytic activation, and RNA-dependent RNA polymerase (RdRp) during transcription. We will assess the advantages and limitations of drugs that precisely target evolutionarily well-conserved domains, which are less likely to mutate, and therefore less likely to escape the effects of these drugs. We propose that a multi-drug cocktail targeting precise proteins, critical to the viral replication cycle, such as spike protein, MPro, and RdRp, will be the most effective strategy of inhibiting SARS-CoV-2 replication and limiting its spread in the general population.

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“…SARS-CoV-2 is spreading much faster than any other respiratory viruses. The incubation period of the virus ranges from 2–14 days, and a fraction of people likely transmit the infection without manifesting any symptoms of the disease (Martinez 2020 ). Currently, there are no effective treatments for COVID-19.…”

Section: Introductionmentioning

confidence: 99%

A review of novel coronavirus disease (COVID-19): based on genomic structure, phylogeny, current shreds of evidence, candidate vaccines, and drug repurposing

et al. 2021

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Coronavirus disease (COVID-19) pandemic is instigated by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). As of March 13, 2021, more than 118.9 million cases were infected with COVID-19 worldwide. SARS-CoV-2 is a positive-sense single-stranded RNA beta-CoV. Most COVID-19 infected individuals recover within 1–3 weeks. Nevertheless, approximately 5% of patients develop acute respiratory distress syndrome and other systemic complications, leading to death. Structural genetic analyses of SARS-CoV-2 have shown genomic resemblances but a low evolutionary correlation to SARS-CoV-1 responsible for the 2002–2004 outbreak. The S glycoprotein is critical for cell adhesion and the entrance of the virus into the host. The process of cell entry uses the cellular receptor named angiotensin-converting enzyme 2. Recent evidence proposed that the CD147 as a SARS-CoV-2′s potential receptor. The viral genome is mainly held by two non-structural proteins (NSPs), ORF1a and ORF1ab, along with structural proteins. Although NSPs are conserved among the βCoVs, mutations in NSP2 and NSP3 may play critical roles in transmitting the virus and cell tropism. To date, no specific/targeted anti-viral treatments exist. Notably, more than 50 COVID-19 candidate vaccines in clinical trials, and a few being administered. Preventive precautions are the primary strategy to limit the viral load transmission and spread, emphasizing the urgent need for developing significant drug targets and vaccines against COVID-19. This review provides a cumulative overview of the genomic structure, transmission, phylogeny of SARS-CoV-2 from Indian clusters, treatment options, updated discoveries, and future standpoints for COVID-19. Supplementary Information The online version contains supplementary material available at 10.1007/s13205-021-02749-0.

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Applicability of Outpatient Quality Indicators for Appropriate Antibiotic Use in a Primary Health Care Area: a Point Prevalence Survey

Cited by 3 publications

References 23 publications

Point prevalence audit surveys of respiratory tract infection consultations and antibiotic prescribing in primary care before and during the COVID-19 pandemic in Ireland

Point prevalence audit surveys of respiratory tract infection consultations and antibiotic prescribing in primary care before and during the COVID-19 pandemic in Ireland

Precision therapeutic targets for COVID-19

A review of novel coronavirus disease (COVID-19): based on genomic structure, phylogeny, current shreds of evidence, candidate vaccines, and drug repurposing

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