TY - JOUR T1 - Comparing antibiotic prescriptions in primary care between SARS-CoV-2 and influenza: a retrospective observational study JF - BJGP Open JO - BJGP Open DO - 10.3399/BJGPO.2022.0049 SP - BJGPO.2022.0049 AU - Martijn Sijbom AU - Frederike L Büchner AU - Nicholas H Saadah AU - Mark GJ de Boer AU - Mattijs E Numans Y1 - 2022/11/16 UR - http://bjgpopen.org/content/early/2022/11/30/BJGPO.2022.0049.abstract N2 - Background Antibiotics are frequently prescribed during viral respiratory infection episodes in primary care. There is limited information about antibiotic prescription during the severe acute respiratory syndrome coronavirus 2 (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.Design & setting An observational cohort study using pseudonymised and coded routine healthcare data extracted from 85 primary care practices in the Netherlands.Method Adult patients with influenza and influenza-like symptoms were included from the 2017 influenza season to the 2020 season. Adult patients with suspected or confirmed COVID-19 were included from the first (15 February 2020–1 August 2020) and second (1 August 2020–1 January 2021) SARS-CoV-2 waves. Proportions of antibiotic prescriptions were calculated for influenza and COVID-19 patients. Odds ratios (ORs) were used to compare the associations of antibiotic prescriptions in COVID-19 patients with risk factors, hospital admission, intensive care unit (ICU) 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% versus 20.7%), difference 11.1% (95% confidence interval [CI] = 8.7 to 13.5). During the second SARS-CoV-2 wave, antibiotic prescriptions were associated with being aged ≥70 years (OR 2.05; 95% CI = 1.43 to 2.93), the number of comorbidities (OR 1.46; 95% CI = 1.18 to 1.82), and admission to hospital (OR 3.19; 95% CI = 2.02 to 5.03) or ICU (OR 4.64; 95% CI = 2.02 to 10.62).Conclusion Antibiotic prescription was less common during the SARS-CoV-2 pandemic than during influenza seasons, and was associated with an adverse course and its risk factors. The findings suggest a relatively targeted prescription policy of antibiotics in primary care during COVID-19. ER -