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

Author:

Shah M12ORCID,Fleming A3ORCID,Barbosa T M3,van der Velden A W4ORCID,Parveen S5,Vellinga A5ORCID

Affiliation:

1. Chief II Antimicrobial Pharmacist, Health Service Executive , Cork , Ireland

2. Pharmaceutical Care Research Group, School of Pharmacy, University College Cork , Cork , Ireland

3. Pharmacy Department, Mercy University Hospital, Grenville Place , Cork , Ireland

4. Julius Center for Health Sciences and Primary Care, UMC Utrecht , Utrecht , Netherlands

5. School of Public Health, Physiotherapy and Sport Science, University College Dublin , Dublin , Ireland

Abstract

Abstract 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.

Funder

Innovative Medicine Initiative 2 Joint Undertaking

Horizon 2020 Research and Innovation Programme

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Pharmacology (medical),Pharmacology,Microbiology (medical)

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