Disease-Specific Quality Indicators for Outpatient Antibiotic Prescribing for Respiratory Infections (ESAC Quality Indicators) Applied to Point Prevalence Audit Surveys in General Practices in 13 European Countries

• Published in: Antibiotics (Basel) Vol. 12; no. 3; p. 572
• Main Authors: Vellinga, Akke, Luke-Currier, Addiena, Garzón-Orjuela, Nathaly, Aabenhus, Rune, Anastasaki, Marilena, Balan, Anca, Böhmer, Femke, Lang, Valerija Bralić, Chlabicz, Slawomir, Coenen, Samuel, García-Sangenís, Ana, Kowalczyk, Anna, Malania, Lile, Tomacinschii, Angela, van der Linde, Sanne R, Bongard, Emily, Butler, Christopher C, Goossens, Herman, van der Velden, Alike W
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01.03.2023; MDPI
• Subjects: Adults; Age; antibiotic prescribing; Antibiotics; audit; Bronchitis; COVID-19; Etiology; Family medicine; Indication; Indicators; Infection; Infections; Lung diseases; Pandemics; Patients; Penicillin; Physicians (General practice); Pneumonia; Prevalence studies (Epidemiology); primary health care; Quality control; quality in healthcare; Quality management; respiratory infections; Respiratory tract; Respiratory tract diseases; Respiratory tract infection; Sinusitis; Surveillance; Surveys; Tetracycline; Tetracyclines; Tonsillitis; Greece; Netherlands; Romania; Belgium; Ireland; Denmark; Poland; United Kingdom; Moldova; Germany; Croatia; Spain; United Kingdom > UK; United States > US; Georgia (country); primary health care; quality in healthcare; antibiotic prescribing; audit; respiratory infections
• ISSN: 2079-6382; 2079-6382
• DOI: 10.3390/antibiotics12030572

Up to 80% of antibiotics are prescribed in the community. An assessment of prescribing by indication will help to identify areas where improvement can be made. A point prevalence audit study (PPAS) of consecutive respiratory tract infection (RTI) consultations in general practices in 13 European countries was conducted in January-February 2020 (PPAS-1) and again in 2022 (PPAS-4). The European Surveillance of Antibiotic Consumption quality indicators (ESAC-QI) were calculated to identify where improvements can be made. A total of 3618 consultations were recorded for PPAS-1 and 2655 in PPAS-4. Bacterial aetiology was suspected in 26% (PPAS-1) and 12% (PPAS-4), and an antibiotic was prescribed in 30% (PPAS-1) and 16% (PPAS-4) of consultations. The percentage of adult patients with bronchitis who receive an antibiotic should, according to the ESAC-QI, not exceed 30%, which was not met by participating practices in any country except Denmark and Spain. For patients (≥1) with acute upper RTI, less than 20% should be prescribed an antibiotic, which was achieved by general practices in most countries, except Ireland (both PPAS), Croatia (PPAS-1), and Greece (PPAS-4) where prescribing for acute or chronic sinusitis (0-20%) was also exceeded. For pneumonia in adults, prescribing is acceptable for 90-100%, and this is lower in most countries. Prescribing for tonsillitis (≥1) exceeded the ESAC-QI (0-20%) in all countries and was 69% (PPAS-1) and 75% (PPAS-4). In conclusion, ESAC-QI applied to PPAS outcomes allows us to evaluate appropriate antibiotic prescribing by indication and benchmark general practices and countries.