The Effect of the COVID-19 Pandemic on Outpatient Antibiotic Prescription Rates in Children and Adolescents—A Claims-Based Study in Germany

Akmatov, Manas K.; Kohring, Claudia; Dammertz, Lotte; Heuer, J.; Below, Maike; Bätzing, Jörg; Holstiege, Jakob

doi:10.3390/antibiotics11101433

Cited by 5 publications

(5 citation statements)

References 11 publications

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“…However, the trend observed during the first year of the pandemic (2020) was obvious in both sexes. Furthermore, in accordance with the findings of previous analyses, fracture incidence rates detected in the second year of the pandemic duplicated values observed in 2020 across all age groups investigated [29,30].…”

Section: Discussionsupporting

confidence: 91%

Incidences for Fractures 2017–2021: What Do We Learn from the COVID-19 Pandemic?

Niemöller,

Tanislav,

Kostev

2023

Healthcare

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Purpose/Introduction: In the present study, we aimed to assess the long-term incidence of fractures and during the COVID-19 pandemic. Methods: The current cohort study included patients who had received an initial fracture diagnosis of any type documented anonymously in the Disease Analyzer database (IQVIA) between 2017 and 2021 by physicians in 941 general practices in Germany. We investigated the development of fracture incidence over this period. Results: A total of 196,211 patients had a fracture diagnosis between 2017 and 2021. The number of patients with fracture diagnosis was highest in 2019 (n = 50,084) and lowest in 2020 (n = 46,227). The mean age of patients increased from 60.8 years in 2017 to 63.3 years in 2021. Between 58% and 60% of patients were female. From 2017 to 2019, the number of fractures documented in the younger age categories remained constant. Between 2019 and 2020, an incidence decrease was documented in the younger age groups (age group 16–40 years: −17.17%; age group 41–60 years: −18.71%; age group 61–80 years: −6.43%). By contrast, a slight increase of 3.03% was identified in the age group >80 years of age. No relevant changes in fracture incidences were noted between 2020 and 2021. Incidence rates decreased for both sexes from 2019 to 2020 (female patients: −6.27%; male patients: −10.18%). In the youngest age group (16–40 years), the decrease observed in 2020 was due to lower incidences for fractures of the upper and lower extremities (−11.9%; −12.5%) and ribs (−50.0%). In the age group ≥80 years, fracture incidences increased for the upper extremity (+2.8%), lower extremity (+8.3%), and femur (+8.3%). Conclusions: The circumstances of the pandemic reduced the incidence of fractures in younger people, probably due to reduced recreational activities, while fracture incidence increased in older people, presumably as a result of lack of support.

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Section: Discussionsupporting

confidence: 91%

Incidences for Fractures 2017–2021: What Do We Learn from the COVID-19 Pandemic?

Niemöller,

Tanislav,

Kostev

2023

Healthcare

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“…Interestingly, the decline observed from 2020 to 2021 (−11.3%) remains within the range of the decreases observed prior to the pandemic, which supports the hypothesis of a collapse in AB prescriptions from 2019 to 2020 and a normalization a year later at a level comparable to the pre-pandemic level. Akmatov and colleagues also observed this effect when they investigated the development of AB prescriptions in children, identifying a dramatic decline from 2019 to 2020 with a slight increase in 2021 [22]. However, regardless of the extent to which the pre-pandemic development and the decline in the incidence of infectious diseases might have influenced the profound reduction in AB prescriptions in 2020, there are a number of other factors that could be responsible for the development observed.…”

Section: Discussionmentioning

confidence: 92%

“…In a study investigating the use of antibiotics during the COVID-19 pandemic in hospitals in China compared to previous rates, a remarkable decrease was noted [21]. In this context, Akmatov and colleagues investigated prescriptions for antibiotics in children (≤14 years) in Germany, detecting an annual decrease of 6% prior to the pandemic, with the figure halving (57%) in 2021 in comparison to the level in 2019 [22].…”

Section: Introductionmentioning

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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“…The decreasing trend in antibiotic prescribing in recent years may also be related to the coronavirus disease 2019 (COVID-19) pandemic. As a matter of fact, a claims-based study of children and adolescents in Germany (N = 9,688,483 participants in 2021) found that the decrease in outpatient antibiotic prescriptions was more pronounced for some months in 2020 compared to prior years, although this effect was temporary [37]. This decrease following the outbreak of the pandemic may have been related to lower access to medical care and partial drug shortages in community pharmacies.…”

Section: Interpretation Of the Findingsmentioning

confidence: 99%

Changes in the Prescription of Antibiotics and Phytopharmaceuticals in Children Treated for Acute Upper and Lower Respiratory Tract Infections in Pediatric Practices in Germany in 2013, 2018, and 2022

Kostev,

van den Boom,

Tanislav

et al. 2023

Antibiotics

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Background: Little is known about the recent trends in antibiotic and phytopharmaceutical prescribing for acute upper (URIs) and lower respiratory tract infections (LRIs) in children and adolescents. Therefore, this study investigated changes in the prescription of antibiotics and phytopharmaceuticals in children diagnosed with acute URIs and LRIs in pediatric practices in Germany in 2013, 2018, and 2022. Methods: The present retrospective study included children aged 2–12 years diagnosed with acute URIs or LRIs in one of 180 pediatric practices in 2013, 2018, and 2022. The URIs included nasopharyngitis, sinusitis, pharyngitis, tonsillitis, laryngitis and tracheitis, and upper respiratory infections of multiple and unspecified sites, while the LRIs corresponded to bronchitis. The primary outcomes were the proportion of children being prescribed antibiotics and the proportion of those being prescribed phytopharmaceuticals. Results: A total of 120,894 children were diagnosed with acute URIs or LRIs in 2013 compared to 116,844 in 2018 and 127,821 in 2022. The prevalence of antibiotic prescription decreased for all diagnoses between 2013 and 2022. This decrease was statistically significant for both 2013–2018 and 2018–2022 for nasopharyngitis, pharyngitis, and bronchitis. Meanwhile, there was a significant increase in the use of phytopharmaceuticals for all diagnoses between 2013 and 2018. The prevalence of phytopharmaceutical prescription decreased slightly between 2018 and 2022, but this decrease was generally not statistically significant. Conclusions: The prescription of antibiotics has decreased and that of phytopharmaceuticals has increased in children diagnosed with acute URIs and LRIs in Germany over the last decade. More data are needed to corroborate these findings in other settings.

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The Effect of the COVID-19 Pandemic on Outpatient Antibiotic Prescription Rates in Children and Adolescents—A Claims-Based Study in Germany

Cited by 5 publications

References 11 publications

Incidences for Fractures 2017–2021: What Do We Learn from the COVID-19 Pandemic?

Incidences for Fractures 2017–2021: What Do We Learn from the COVID-19 Pandemic?

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

Changes in the Prescription of Antibiotics and Phytopharmaceuticals in Children Treated for Acute Upper and Lower Respiratory Tract Infections in Pediatric Practices in Germany in 2013, 2018, and 2022

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