97 Comparing antibiotic prescriptions in primary care between SARS-CoV-2 and influenza 4 Introduction The new SARS-CoV-2, like all viral respiratory tract infections (RTIs), carries a risk of bacterial superinfection (1–3). Antibiotics are often prescribed by GPs to reduce morbidity and mortality owing to these bacterial superinfections, particularly in the presence of certain risk factors (1,4–7). Influenza is a recognised major seasonal cause of viral RTIs and a trigger comparable with SARS-CoV-2 with regard to the risk of bacterial superinfections (4). There is limited information on the extent of antibiotic prescriptions in COVID-19 patients in primary care and the associations of these prescriptions with outcomes of interest. The main disadvantage of the use of antibiotics is the development of antimicrobial resistance (AMR) (8). Another downside is the occurrence of potential side effects of antibiotics. Prudent antibiotic prescription is therefore still indicated and should be sustained in the current pandemic circumstances to reduce the risk of inappropriate antibiotic prescriptions to avoid unnecessary harm. Antibiotic prescriptions were compared during recent influenza seasons with those of the first and second SARS-CoV-2 waves in The Netherlands. In addition, associations between antibiotic prescriptions and hospital admissions, ICU admissions, mortality, and various known risk factors were calculated. Method Study design and setting Data collection For this observational study, pseudonymised, coded routine healthcare data were used from patients enlisted between 2016 and 2020 with one of the 85 general practices participating in the Extramural LUMC Academic Network (ELAN) medical registry, operating out of the Leiden and The Hague area. GPs involved in this network provide complete and actively updated longitudinal data on their patients via their electronic medical records (EMRs). An informed opt-out procedure for the use of these pseudonymised data is in place.
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