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

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  • Akke Vellinga
  • Addiena Luke-Currier
  • Nathaly Garzón-Orjuela
  • Aabenhus, Rune Munck
  • Marilena Anastasaki
  • Anca Balan
  • Femke Böhmer
  • Valerija Bralić Lang
  • Slawomir Chlabicz
  • Samuel Coenen
  • Ana García-Sangenís
  • Anna Kowalczyk
  • Lile Malania
  • Angela Tomacinschii
  • Sanne R. van der Linde
  • Emily Bongard
  • Christopher C. Butler
  • Herman Goossens
  • Alike W. van der Velden
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.
Udgave nummer3
Antal sider15
StatusUdgivet - 2023

Bibliografisk note

Funding Information:
This work was supported by the Innovative Medicine Initiative 2 Joint Undertaking, grant number 820755 (VALUE-Dx).

Publisher Copyright:
© 2023 by the authors.

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