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

• Main Authors: Akke Vellinga (Author), Addiena Luke-Currier (Author), Nathaly Garzón-Orjuela (Author), Rune Aabenhus (Author), Marilena Anastasaki (Author), Anca Balan (Author), Femke Böhmer (Author), Valerija Bralić Lang (Author), Slawomir Chlabicz (Author), Samuel Coenen (Author), Ana García-Sangenís (Author), Anna Kowalczyk (Author), Lile Malania (Author), Angela Tomacinschii (Author), Sanne R. van der Linde (Author), Emily Bongard (Author), Christopher C. Butler (Author), Herman Goossens (Author), Alike W. van der Velden (Author)
• Format: Book
• Published: MDPI AG, 2023-03-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 10.3390/antibiotics12030572; 2079-6382
• Keywords: audit; primary health care; quality in healthcare; respiratory infections; antibiotic prescribing; Therapeutics. Pharmacology; RM1-950
• Source: Antibiotics, Vol 12, Iss 3, p 572 (2023)

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.