Antibiotics-Basel最新文献

{"title":"Kinetic Patterns of Antibiotic Consumption in German Acute Care Hospitals from 2017 to 2023.","authors":"Birgitta Schweickert, Niklas Willrich, Marcel Feig, Marc Schneider, Michael Behnke, Luis Alberto Peña Diaz, Christine Geffers, Imke Wieters, Karin Gröschner, Doreen Richter, Alexandra Hoffmann, Tim Eckmanns, Muna Abu Sin","doi":"10.3390/antibiotics14030316","DOIUrl":"10.3390/antibiotics14030316","url":null,"abstract":"<p><p><b>Background:</b> Antimicrobial consumption (AMC) patterns, besides prescribing behaviors, reflect the changing epidemiology of infectious diseases. Routine surveillance data have been used to investigate the development of AMC from 2017 to 2023 and the impact of COVID-19 within the context of the framing time periods. <b>Methods:</b> Data from 112 hospitals, continuously participating from 2017 to 2023 in the national surveillance system of hospital antimicrobial consumption based at the Robert Koch Institute, were analyzed according to the WHO ATC (Anatomical Therapeutic Chemical)/DDD (Defined Daily Dose) method and categorized according to the WHO AWaRe-classification. AMC was quantified by consumption density (CD) expressed in DDD/100 patient days (PD) and DDD/100 admissions (AD). The time period was subdivided into three phases: pre-pandemic phase (2017-2019), main pandemic phase (2020-2021) and transition phase (2022-2023). Linear regression models have been used to determine the presence of an overall trend, the change in intra-phasic trends and phase-specific mean consumption levels over time. <b>Results:</b> From 2017 to 2023 total antibiotic consumption decreased by 7% from 57.1 to 52.9 DDD/100 PD. Four main kinetic patterns emerged across different antibiotic classes: Pattern 1 displays a decreasing pre-pandemic trend, which slowed down throughout the pandemic and transition phase and was exhibited by second-generation cephalosporins and fluoroquinolones. Pattern 2 reveals a rising pre-pandemic trend, which decelerated in the pandemic phase and accelerated again in the transition phase and was expressed by aminopenicillins/beta-lactamase inhibitors, beta-lactamase sensitive pencillins, azithromycin and first-generation cephalosporins. Pattern 3 shows elevated mean consumption levels in the pandemic phase exhibited by carbapenems, glycopeptides, linezolid and third-generation cephalosporins. Pattern 4 reveals a rising trend throughout the pre-pandemic and pandemic phase, which reversed in the transition phase without achieving pre-pandemic levels and was expressed by beta-lactamase resistant penicillins, daptomycin, fosfomycin (parenteral) and ceftazidime/avibactam. <b>Conclusions:</b> Kinetic consumption patterns across different antibiotic classes might reflect COVID-19-related effects and associated changes in the epidemiology of co-circulating pathogens and health care supply. Broad-spectrum antibiotics with persisting elevated consumption levels throughout the transition phase require special attention and focused antimicrobial stewardship activities.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 3","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11939389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ICD-10 Codes to Identify Adverse Drug Events Associated with Antibiotics in Administrative Data.","authors":"Hannah Lishman, Amber Cragg, Erica Chuang, Carl Zou, Fawziah Marra, Jennifer Grant, David M Patrick, Corinne M Hohl","doi":"10.3390/antibiotics14030314","DOIUrl":"10.3390/antibiotics14030314","url":null,"abstract":"<p><p>Antibiotics are among the most used therapeutics in primary care, and while their benefits are clear, the potential harms related to adverse drug events (ADEs) cannot be ignored. We outline the creation of a comprehensive list of diagnostic codes describing antibiotic-associated ADEs resulting in presentations to acute care hospitals. <b>Methods:</b> Previously published ADE codes were used to link BC hospitalizations to prior outpatient antibiotic prescriptions and were restricted based on whether patients received an antibiotic within a month prior to the ADE-related hospitalization. The code list was reviewed by two clinical experts independently for the likelihood of being antibiotic-associated. The inter-rater reliability was calculated using Kappa scores with 95% confidence intervals (CIs). <b>Results</b>: Of the 695 ICD-10 ADE codes with evidence of recent antibiotic administration, 72, 68, and 555 codes were considered likely, possibly, and unlikely antibiotic-associated, respectively. <b>Conclusions:</b> We outline a methodology for developing an ICD-10 code list for antibiotic-associated ADEs severe enough to warrant hospital admission. This will help to improve the use of administrative data to capture antibiotic-associated ADEs.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 3","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11939740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nocardia Isolation in People with Cystic Fibrosis and Non-CF Bronchiectasis: A Multicenter Italian Study.","authors":"Laura Venditto, Daniela Dolce, Silvia Campana, Pamela Vitullo, Marco Di Maurizio, Cristina Fevola, Francesca Lucca, Giovanni Taccetti, Vito Terlizzi","doi":"10.3390/antibiotics14030317","DOIUrl":"10.3390/antibiotics14030317","url":null,"abstract":"<p><p><b>Background:</b><i>Nocardia</i> species are an emergent pathogen in people with CF (pwCF) or bronchiectasis. Their clinical role and management remain unclear, and their isolation is a challenge. In this paper, we describe four cases of Nocardia detection, in two pwCF and two patients with non-CF bronchiectasis or primary ciliary dyskinesia (PCD). <b>Methods:</b> We conducted a multicenter retrospective study, involving pwCF and non-CF people with bronchiectasis who presented with a <i>Nocardia</i> detection and were followed at three CF Italian centers (Florence, Verona, and Cerignola). <b>Results:</b><i>Nocardia</i> detection was associated with clinical and radiological respiratory exacerbation and decline in lung function. In one CF patient, <i>Nocardia</i> was not detected in sputum cultures after starting Elexacaftor-Tezacaftor-Ivacaftor therapy. <b>Conclusions:</b> Managing <i>Nocardia</i> detection in patients with underlying lung diseases such as CF, PCD, or bronchiectasis presents significant challenges for clinicians.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 3","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11939271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Tuberculosis and Drug Resistance in Serbia: A Ten-Year Experience from a Tertiary Center.","authors":"Mihailo Stjepanovic, Snjezana Mijatovic, Nikola Nikolic, Nikola Maric, Goran Stevanovic, Ivan Soldatovic, Aleksandra Barac","doi":"10.3390/antibiotics14030320","DOIUrl":"10.3390/antibiotics14030320","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB) remains a leading cause of mortality worldwide, particularly in low- and middle-income countries. The rise of multidrug-resistant TB (MDR-TB) poses significant challenges to global health. This study reviews the experience of the largest pulmonology center in Serbia, a country with low MDR-TB incidence, focusing on TB prevalence, resistance detection, and treatment strategies between 2012 and 2021.</p><p><strong>Methods: </strong>We retrospectively analyzed a total of 1239 patients who were diagnosed and treated for TB in the period from 2012 to 2021 at University Clinical Center of Serbia.</p><p><strong>Results: </strong>Drug resistance was identified in 21 patients (1.7%), with the highest resistance to rifampicin (1.4%) and isoniazid (1.3%). Pyrazinamide and streptomycin resistance were detected in only a few cases. Patients with resistant TB were younger on average, though the difference was not statistically significant (46.4 ± 19.1 vs. 53.6 ± 18.4, <i>p</i> = 0.079). Prior TB history was more frequent in the resistant group, almost reaching statistical significance (4 vs. 82, <i>p</i> = 0.052).</p><p><strong>Conclusions: </strong>These findings underscore the critical importance of sustained surveillance, particularly of latent and drug-resistant TB forms, in alignment with the World Health Organization's (WHO) TB control strategy to preserve Serbia's low-incidence status. Moreover, given Serbia's strategic location on a major migration route, there is an elevated risk of new TB cases emerging and potential shifts in TB-drug-resistance patterns developing in the future.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 3","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11939474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Amoxicillin Shortage on Pediatric Antibiotic Prescriptions in Primary Care.","authors":"Federica Pagano, Giulio De Marco, Benedetta Trojano, Chiara Amato, Maria Micillo, Gaetano Cecere, Alfredo Guarino, Andrea Lo Vecchio","doi":"10.3390/antibiotics14030313","DOIUrl":"10.3390/antibiotics14030313","url":null,"abstract":"<p><p><b>Background/Objectives:</b> A previous study settled in the Campania Region (Southern Italy) has proven the effectiveness of a multifaceted antimicrobial stewardship program in reducing prescription rates and use of broad-spectrum molecules in the Primary Care setting. Since autumn 2022, the amoxicillin shortage has been reported at a national level, and respiratory pathogens resurged in children after the easing of COVID-19 pandemic restrictions. We aimed to assess the impact of amoxicillin shortage on antimicrobial prescription patterns and quality indexes in the same setting as the past AMS campaign. <b>Methods:</b> We conducted a retrospective review of antibiotic prescriptions in a primary care pediatric practice, focusing on amoxicillin, amoxicillin-clavulanate, third-generation cephalosporins, macrolides, and quinolones. To assess drug accessibility, we monitored antibiotic availability in pharmacies within the same healthcare district. We then analyzed monthly prescription rates per 100 consultations in relation to drug availability patterns and calculated the amoxicillin/amoxicillin-clavulanate index and the Access/Watch index as quality indicators. <b>Results:</b> From November 2022 to May 2023, 90% of the surveyed pharmacies reported an amoxicillin shortage lasting 5 to 7 months. Concomitantly, we observed a significant shift in the prescription pattern for amoxicillin-clavulanate (3.53 to 13.82; <i>p</i> = 0.009) and third-generation cephalosporins (2.45 to 4.83; <i>p</i> = 0.026), that resulted in a decline of the amoxicillin/amoxicillin-clavulanate index (1.38 to 0.56; <i>p</i> = 0.009). <b>Conclusions:</b> The lack of amoxicillin could have led to increased prescriptions of second-line antibiotics in Italian regions, reverting the effect of successful stewardship measures.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 3","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11939257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Cyclic Antimicrobial Peptide C-LR18 Has Enhanced Antibacterial Activity, Improved Stability, and a Longer Half-Life Compared to the Original Peptide.","authors":"Zhihua Pei, Qiaoxi Song, Jingqi Xu, Shuang Yu, Hongxia Ma","doi":"10.3390/antibiotics14030312","DOIUrl":"10.3390/antibiotics14030312","url":null,"abstract":"<p><p><b>Background:</b> LR18 is an α₋helical AMP with high antimicrobial activity, low hemolytic activity, and low cytotoxicity. However, the susceptibility to degradation of the peptidase enzyme and a short half-life hinder its application as a therapeutic agent. Improving the stability and prolonging the half-life of LR18 are crucial to accelerate its application in the treatment of infectious diseases. <b>Methods:</b> A new cyclic peptide, C-LR18, was designed and synthesized through end-to-end cyclization of LR18 via disulfide bonds. The biological activity, half-life, and therapeutic effect of C-LR18 on <i>Escherichia coli</i>₋infected mice were studied. <b>Results:</b> C-LR18 maintained the characteristics of low cytotoxicity and low hemolytic activity of the original LR18 peptide and had higher antibacterial activity and significantly improved stability. After treatment with 1 mg/mL of trypsin, carboxypeptidase, and papain for 1 h, the MIC of C-LR18 against <i>E. coli</i> ATCC25922 was 4 μM, while that of LR18 had increased to 128 μM. After exposure to 50% serum or artificial gut solution for 30 min, the MIC of C-LR18 against <i>E. coli</i> ATCC25922 increased 4-fold, while that of LR18 increased 16-fold. The half-life of C-LR18 in plasma and in rats was extended to 3.37-fold and 4.46-fold, respectively, that of LR18. The acute toxicity of C-LR18 in mice is lower than many AMPs reported so far (LD50 = 37.8 mg/kg). C-LR18 has a therapeutic effect on <i>E.coli</i>-infected mice. <b>Conclusions:</b> The cyclic peptide C-LR18 has higher antibacterial activity and stability and a longer half-life than LR18 in rats in vitro and in vivo. C-LR18 also has a therapeutic effect on KM mice infected with <i>E. coli</i> and is expected to become a therapeutic drug for bacterial diseases and applied to the treatment of human and veterinary diseases.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 3","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11939470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anacardiaceae Family: Effect of Isolated Compounds and Other Identified Phytochemicals Against Clinically Relevant <i>Candida</i> Species-A Short Review.","authors":"Rosane Nassar Meireles Guerra, Aluísio Silva Oliveira, Josivan Regis Farias, Danielle Cristine Gomes Franco, Pamela Gomes Santos, Nicolle Teixeira Barbosa, Simone Batista Muniz, Afonso Gomes Abreu, Flavia Raquel Fernandes Nascimento","doi":"10.3390/antibiotics14030308","DOIUrl":"10.3390/antibiotics14030308","url":null,"abstract":"<p><p><b>Background:</b> The increased rates of common fungal diseases are a constant challenge. Therefore, the search for plant-based compounds with antifungal activity, particularly ones against <i>Candida</i> species, is always relevant in the medical context. However, most of the studies have focused on screening the antifungal activity of extracts rather than isolated compounds. Based on this, we aimed to analyze and organize a comprehensive overview of the antifungal and other biological activities of isolated compounds found in Anacardiaceae family vegetal species, covering mechanisms of action and potential therapeutic applications. <b>Results:</b> The extracts, essential oils, and compounds are frequently assayed for anti-<i>Candida</i> activity using the in vitro minimum inhibitory concentration (MIC), minimum fungicide concentration (MFC), and halo inhibition assays. <i>Candida albicans</i>, <i>C. tropicalis</i>, <i>C. parapsilosis</i>, <i>C. glabrata</i>, <i>C. krusei</i>, and <i>C. guilliermondii</i> were the most tested fungus species. Essential oils were the most used form (37% of the studies). The isolated compounds included shikimic acid, 2-hydroxy-1,8-cineole β-D-glucopyranoside, myricitrin, cardanol, estragole, trans-anethole, β-caryophyllene, myrcene, catechin-3-O-rhamnoside, <i>β</i>-sitosterol-3-O-glucoside, 24Z-isomasticadienolic acid, oleanolic acid, pistagremic acid, apigenin, sakuranetin, oleanolic aldehyde, and integriside. <b>Conclusions</b>: Our data indicate that the compounds isolated from Anacardiaceae species show promise for developing new therapeutic antifungal drugs, mainly if we consider their other biological activities, including anti-inflammatory, antioxidant, and apoptotic effects. In this context, they may be candidates for future treatments of fungal infections, especially in combination with conventional antifungals or when used in nanostructured formulations, which may result in a new avenue of using plant extracts and isolated compounds.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 3","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11939211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibacterial Effects of Synthetic Plantaricins Against <i>Staphylococcus aureus</i>.","authors":"Seung-Eun Oh, Sojeong Heo, Gawon Lee, Jina Kim, Mi-Sun Kwak, Do-Won Jeong","doi":"10.3390/antibiotics14030311","DOIUrl":"10.3390/antibiotics14030311","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Plantaricins without a signal sequence were synthesized based on bacteriocins, plantaricins A, E, F, J, and K, of <i>Lactiplantibacillus plantarum</i> KM2. The antibacterial activities of four combinations of synthetic plantaricins-spPlnA, E&F, E&J, and J&K-were identified against <i>Staphylococcus aureus</i> ATCC 12692. And in this experiment, we aimed to identify the antimicrobial mechanism of the synthesized plantaricin sample against <i>S. aureus</i>. <b>Methods/Results:</b> The minimal inhibitory concentrations for each combination were 1.4 μg/mL, 1.8 μg/mL, 1.6 μg/mL, and 1.6 μg/mL, respectively. Raman spectra changed after treating <i>S. aureus</i> ATCC 12692 with synthetic plantaricins. Furthermore, transmission electron microscopy results revealed that the four synthetic plantaricin combinations could induce the cell lysis of <i>S. aureus</i> ATCC 12692. Finally, the four synthetic plantaricin combinations maintained their antibacterial effect at temperatures below 40 °C, and at pH levels of pH = (4-7). Except for spPlnJ&K, they are stable against the action of α-amylase and lysozyme. Overall, these results indicate that, excepting spPlnJ&K, the three synthetic plantaricin combinations exhibit similar antibacterial activity. <b>Conclusions:</b> Through this study, we confirmed that synthetic plantaricin exhibited antimicrobial activity against <i>S. aureus</i>, demonstrating its potential as a direct antimicrobial agent. However, since the antimicrobial activity decreased due to protease, it was confirmed that its use is limited in environments where protease is present.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 3","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11939208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibiotic Usage for Treatment of Acute Upper Respiratory Tract Infections in Children in Lithuania from 2018 to 2022.","authors":"Tadas Alčauskas, Kristina Garuolienė, Sigita Burokienė","doi":"10.3390/antibiotics14030310","DOIUrl":"10.3390/antibiotics14030310","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Acute upper respiratory tract infections (URIs) are defined as inflammatory diseases of the nose, sinuses, pharynx, larynx, or trachea. They are common in children. The prescription of antibiotics for the treatment of URIs became a relevant theme in the scientific literature in recent decades. One of the most important ways to deal with increasing antimicrobial resistance is rational antibiotic therapy. This study aimed to evaluate the tendencies of antibiotic prescribing practices for Lithuanian children with URIs from 2018 to 2022. We describe how many children with URIs were prescribed antibiotics, which antibiotics were used, and whether prescribing practices meet national guidelines. <b>Methods</b>: Secondary data, which were used in this observational study, were collected from the Lithuanian Compulsory Health Insurance Fund (CHIF) electronic records. The study population consisted of children aged between 0 and 18 years who visited their primary care doctors (pediatricians or family doctors) between January 2018 and December 2022 and were prescribed antibiotics for the treatment of URIs. <b>Results</b>: Between 2018 and 2022, there were 445,328 visits reported when antibiotics, which belong to the J01 group according to the Anatomical Therapeutic Chemical Classification (ATC), were prescribed to children aged 0-18. In more than half of the visits (51.70%), children aged 0-5 were consulted. Penicillins were mostly prescribed for the treatment of acute nasopharyngitis. Macrolides were mostly used to treat acute laryngitis and tracheitis. Of all penicillin-class antibiotics, the most popular choice was amoxycillin. The primary choice of cephalosporin was cefadroxil, and the primary choice of macrolide was clarithromycin. <b>Conclusions</b>: During the period of 2018-2022, the number of prescriptions for antibiotics for URTIs decreased, but prescriptions for penicillin-class antibiotics increased in a relative manner. The most common diagnoses during these visits were acute tonsillitis and acute pharyngitis, and most antibiotic prescriptions were for children in the 0-5 age group. If Lithuania's National Recommendations on the Rational Use of Antibiotics were implemented during the analyzed period, the prescribing tendencies would not meet them.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 3","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11939643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increase in Antibiotic Utilisation in Primary Care Post COVID-19 Pandemic.","authors":"Sky Wei Chee Koh, Si Hui Low, Jun Cong Goh, Li Yang Hsu","doi":"10.3390/antibiotics14030309","DOIUrl":"10.3390/antibiotics14030309","url":null,"abstract":"<p><p><b>Introduction</b>: The COVID-19 pandemic has disrupted antibiotic use; easing public health measures may alter infection presentations and antibiotic prescribing in primary care. The study investigated post-pandemic antibiotic utilisation trends in primary care. <b>Methods</b>: A multi-centre, retrospective cohort study was conducted across seven public primary care clinics in Western Singapore, which included all patients prescribed oral antibiotics between 2022 and 2023. Descriptive statistics were used to visualise the prevalence and conditions of the prescribed antibiotics. Antibiotic quality was evaluated using the WHO's AWaRe (access, watch, reserve) classification. Antibiotic use was quantified using the number of items dispensed per 1000 inhabitants (NTI), defined daily doses (DDD) per 1000 inhabitants per day (DID), and DDD per 100 visits. Segmented regression analysis was applied to monthly prescriptions to assess the utilisation trends. <b>Results</b>: Antibiotic prescription rates increased significantly, from 3.5% in 2022 to 4.0% in 2023 (<i>p</i> = 0.001), with a 9.5% relative increase (38,920 prescriptions for 1,112,574 visits to 42,613 prescriptions for 1,063,646 visits). Respiratory conditions drove the increase in antibiotics use, with a 68.3% rise in prescriptions, with upper respiratory tract infections being the most common diagnosis for antibiotic prescriptions (n = 9296 prescriptions in 2023), with a steady monthly upward trend. Access group antibiotics accounted for >90% of prescriptions. The most antibiotics were prescribed for acne, with 36,304 DDD per 100 visits in 2023. Both NTI and DID significantly increased in 2022, largely contributed by a >100% increase in Watch group antibiotic use. Total antibiotic NTI dipped slightly in 2023, with a stable trend in both NTI and DID for all antibiotics. <b>Conclusions</b>: The post-COVID-19 pandemic surge in the antibiotic prescription rate for respiratory conditions and Watch group antibiotic use highlight the need for targeted stewardship interventions. Optimising acne treatment and diagnosis coding are key strategies to further reduce unnecessary prescriptions.</p>","PeriodicalId":54246,"journal":{"name":"Antibiotics-Basel","volume":"14 3","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11939422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}