Background: Antibiotics are frequently prescribed during viral respiratory infection episodes in primary care. There is limited information about antibiotic prescription during the SARS-CoV-2 pandemic in primary care and its association with risk-factors for an adverse course.
Aim: To compare the proportion of antibiotic prescriptions between patients with COVID-19 and influenza or influenza-like-symptoms, and to assess the association between antibiotic prescriptions and risk-factors for an adverse course of COVID-19.DesignAn observational cohort study using pseudonymised and coded routine healthcare data extracted from 85 primary care practices in the Netherlands.
Method: Adult patients with influenza, influenza-like-symptoms, and suspected or confirmed COVID-19 during the period 2017 up until 2020 were included. We calculated proportions of antibiotic prescriptions for influenza and COVID-19 patients and odds...
Show moreBackground: Antibiotics are frequently prescribed during viral respiratory infection episodes in primary care. There is limited information about antibiotic prescription during the SARS-CoV-2 pandemic in primary care and its association with risk-factors for an adverse course.
Aim: To compare the proportion of antibiotic prescriptions between patients with COVID-19 and influenza or influenza-like-symptoms, and to assess the association between antibiotic prescriptions and risk-factors for an adverse course of COVID-19.DesignAn observational cohort study using pseudonymised and coded routine healthcare data extracted from 85 primary care practices in the Netherlands.
Method: Adult patients with influenza, influenza-like-symptoms, and suspected or confirmed COVID-19 during the period 2017 up until 2020 were included. We calculated proportions of antibiotic prescriptions for influenza and COVID-19 patients and odds ratios (ORs) comparing the associations of antibiotic prescriptions in COVID-19 patients with risk factors, hospital admission, intensive care (IC) admission, and mortality.
Results: The proportion of antibiotic prescriptions during the first SARS-CoV-2 wave was lower than during the 2020 influenza season (9.6% vs 20.7%), difference 11.1% (95%CI:8.7-13.5). During the second SARS-CoV-2 wave, antibiotic prescriptions were associated with being older than 70 (OR 2.05 95% CI:1.43-2.93), the number of comorbidities (OR 1.46 95% CI:1.43-2.93) and admission to hospital (OR 3.19 95% CI:2.02-5.03) or IC (OR 4.64 95% CI:2.02-10.62).
Conclusion: Antibiotic prescription was less common during the SARS-CoV-2 pandemic than during influenza seasons and associated with an adverse course and its risk factors. Our findings suggest a relatively targeted prescription policy of antibiotics in primary care during COVID.
Keywords: Primary healthcare; SARS-CoV-2; antibiotics; influenza.
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