Significance of the detection of Influenza and other respiratory viruses for Antibiotic Stewardship: The lessons from post-pandemic period.

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Significance of the detection of Influenza and other respiratory viruses for Antibiotic Stewardship: The lessons from post-pandemic period.

Int J Infect Dis. 2018 Oct 10;:

Authors: Taymaz T, Ergönül Ö, Kebapcı A, Okyay R

Abstract
OBJECTIVE: We aimed to describe the factors associated with antibiotic use in upper respiratory tract infections (URTI) in post-pandemic influenza period.
METHODS: We included all the consecutive patients, who applied to emergency and outpatient departments with the symptoms of influenza like illness (ILI) between January and June 2011 in a private 265 bed hospital in Istanbul, Turkey.
RESULTS: Out of 1270 patients, 100 were tested for Sreptocococcus A infection and 16 (16%) were found to be positive, 36 were tested for RSV and five patients were found to be positive. Influenza rapid test (chromatographic) was perfomed among 325 patients, and 45% were found to be Influenza A or B positive. In total 500 patients (40%) were prescribed antibiotics, and these were fluoroquinolones (12%), macrolides (10%), amoxicillin-clavulonate (10%), cefuroxime (7%), third generation cephalosporins (3%). In multivariate analysis, antibiotic prescription was found to decreased by diagnosis of influenza, whereas increased by >65years of age, CRP >20, PMNL >80%, detection of rales in auscultation, presesence of cough, comorbidities, and having chest x-ray.
CONCLUSION: Diagnosis of influenza is important for implementation of antimicrobial stewardship programs. Each institution should implement an algorithm for diagnosis and management of URTI. The biomarkers such as CRP and procalcitonin should be used more effectively.

PMID: 30315991 [PubMed - as supplied by publisher]