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Article

Impact of the COVID-19 Pandemic on Antibiotic Prescribing for Common Infections in The Netherlands: A Primary Care-Based Observational Cohort Study

Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
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Academic Editors: Masafumi Seki and Rita Murri
Antibiotics 2021, 10(2), 196; https://doi.org/10.3390/antibiotics10020196
Received: 25 January 2021 / Revised: 9 February 2021 / Accepted: 15 February 2021 / Published: 18 February 2021
(This article belongs to the Section Antibiotics Use and Antimicrobial Stewardship)
In 2020, the COVID-19 pandemic brought dramatic changes in the delivery of primary health care across the world, presumably changing the number of consultations for infectious diseases and antibiotic use. We aimed to assess the impact of the pandemic on infections and antibiotic prescribing in Dutch primary care. All patients included in the routine health care database of the Julius General Practitioners’ Network were followed from March through May 2019 (n = 389,708) and March through May 2020 (n = 405,688). We extracted data on consultations for respiratory/ear, urinary tract, gastrointestinal and skin infections using the International Classification of Primary Care (ICPC) codes. These consultations were combined in disease episodes and linked to antibiotic prescriptions. The numbers of infectious disease episodes (total and those treated with antibiotics), complications, and antibiotic prescription rates (i.e., proportion of episodes treated with antibiotics) were calculated and compared between the study periods in 2019 and 2020. Fewer episodes were observed during the pandemic months than in the same months in 2019 for both the four infectious disease entities and complications such as pneumonia, mastoiditis and pyelonephritis. The largest decline was seen for gastrointestinal infections (relative risk (RR), 0.54; confidence interval (CI), 0.51 to 0.58) and skin infections (RR, 0.71; CI, 0.67 to 0.75). The number of episodes treated with antibiotics declined as well, with the largest decrease seen for respiratory/ear infections (RR, 0.54; CI, 0.52 to 0.58). The antibiotic prescription rate for respiratory/ear infections declined from 21% to 13% (difference −8.0% (CI, −8.8 to −7.2)), yet the prescription rates for other infectious disease entities remained similar or increased slightly. The decreases in primary care infectious disease episodes and antibiotic use were most pronounced in weeks 15–19, mid-COVID-19 wave, after an initial peak in respiratory/ear infection presentation in week 11, the first week of lock-down. In conclusion, our findings indicate that the COVID-19 pandemic has had profound effects on the presentation of infectious disease episodes and antibiotic use in primary care in the Netherlands. Consequently, the number of infectious disease episodes treated with antibiotics decreased. We found no evidence of an increase in complications. View Full-Text
Keywords: COVID-19; pandemic; antibiotic; infectious disease; respiratory tract infection; urinary tract infection; pneumonia; routine care data; complications COVID-19; pandemic; antibiotic; infectious disease; respiratory tract infection; urinary tract infection; pneumonia; routine care data; complications
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MDPI and ACS Style

van de Pol, A.C.; Boeijen, J.A.; Venekamp, R.P.; Platteel, T.; Damoiseaux, R.A.M.J.; Kortekaas, M.F.; van der Velden, A.W. Impact of the COVID-19 Pandemic on Antibiotic Prescribing for Common Infections in The Netherlands: A Primary Care-Based Observational Cohort Study. Antibiotics 2021, 10, 196. https://doi.org/10.3390/antibiotics10020196

AMA Style

van de Pol AC, Boeijen JA, Venekamp RP, Platteel T, Damoiseaux RAMJ, Kortekaas MF, van der Velden AW. Impact of the COVID-19 Pandemic on Antibiotic Prescribing for Common Infections in The Netherlands: A Primary Care-Based Observational Cohort Study. Antibiotics. 2021; 10(2):196. https://doi.org/10.3390/antibiotics10020196

Chicago/Turabian Style

van de Pol, Alma C., Josi A. Boeijen, Roderick P. Venekamp, Tamara Platteel, Roger A.M.J. Damoiseaux, Marlous F. Kortekaas, and Alike W. van der Velden. 2021. "Impact of the COVID-19 Pandemic on Antibiotic Prescribing for Common Infections in The Netherlands: A Primary Care-Based Observational Cohort Study" Antibiotics 10, no. 2: 196. https://doi.org/10.3390/antibiotics10020196

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