Antibiotic expectation, behaviour, and receipt among patients presenting to emergency departments with uncomplicated upper respiratory tract infection during the COVID-19 pandemic
ABSTRACT: Objectives: Pre-COVID-19 pandemic, patients who attended the emergency department (ED) for upper respiratory tract infection (URTI) were more likely to receive antibiotics if they expected them. These expectations could have changed with the change in health-seeking behaviour during the p...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-06-01
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| Series: | Journal of Global Antimicrobial Resistance |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213716523000401 |
| _version_ | 1797802277735497728 |
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| author | Zhilian Huang Win Sen Kuan Hann Yee Tan Eillyne Seow Ling Tiah Li Lee Peng Yanyi Weng Angela Chow |
| author_facet | Zhilian Huang Win Sen Kuan Hann Yee Tan Eillyne Seow Ling Tiah Li Lee Peng Yanyi Weng Angela Chow |
| author_sort | Zhilian Huang |
| collection | DOAJ |
| description | ABSTRACT: Objectives: Pre-COVID-19 pandemic, patients who attended the emergency department (ED) for upper respiratory tract infection (URTI) were more likely to receive antibiotics if they expected them. These expectations could have changed with the change in health-seeking behaviour during the pandemic. We assessed the factors associated with antibiotics expectation and receipt for uncomplicated URTI patients in four Singapore EDs during the COVID-19 pandemic. Methods: We conducted a cross-sectional study on adult patients with URTI from March 2021 to March 2022 in four Singapore EDs and assessed the determinants of antibiotics expectation and receipt using multivariable logistic regression models. We also assessed the reasons patients expect antibiotics during their ED visit. Results: Among 681 patients, 31.0% expected antibiotics while 8.7% received antibiotics during their ED visit. Factors (adjusted odds ratio [95% confidence interval]) that significantly influenced expectation for antibiotics include: 1) prior consultation for current illness with (6.56 [3.30–13.11]) or without (1.50 [1.01–2.23]) antibiotics prescribed; 2) anticipation for COVID-19 test (1.56 [1.01–2.41]); and 3) poor (2.16 [1.26–3.68]) to moderate (2.26 [1.33–3.84]) knowledge on antibiotics use and resistance. Patients expecting antibiotics were 10.6 times (10.64 [5.34–21.17]) more likely to receive antibiotics. Those with tertiary education were twice (2.20 [1.09–4.43]) as likely to receive antibiotics. Conclusion: In conclusion, patients with URTI who expected antibiotics to be prescribed remained more likely to receive it during the COVID-19 pandemic. This highlights the need for more public education on the non-necessity for antibiotics for URTI and COVID-19 to address the problem of antibiotic resistance. |
| first_indexed | 2024-03-13T05:03:20Z |
| format | Article |
| id | doaj.art-f1355ac5fbb5491981599c2b85c5c78f |
| institution | Directory Open Access Journal |
| issn | 2213-7165 |
| language | English |
| last_indexed | 2024-03-13T05:03:20Z |
| publishDate | 2023-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Global Antimicrobial Resistance |
| spelling | doaj.art-f1355ac5fbb5491981599c2b85c5c78f2023-06-17T05:18:27ZengElsevierJournal of Global Antimicrobial Resistance2213-71652023-06-01338996Antibiotic expectation, behaviour, and receipt among patients presenting to emergency departments with uncomplicated upper respiratory tract infection during the COVID-19 pandemicZhilian Huang0Win Sen Kuan1Hann Yee Tan2Eillyne Seow3Ling Tiah4Li Lee Peng5Yanyi Weng6Angela Chow7Department of Preventive and Population Medicine, Office of Clinical Epidemiology, Analytics, and Knowledge [OCEAN], Tan Tock Seng Hospital, SingaporeDepartment Emergency Medicine, National University Hospital, Singapore; Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, SingaporeAcute and Emergency Care Department, Khoo Teck Puat Hospital, SingaporeAcute and Emergency Care Department, Khoo Teck Puat Hospital, SingaporeAccident and Emergency Department, Changi General Hospital, SingaporeDepartment Emergency Medicine, National University Hospital, Singapore; Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, SingaporeDepartment Emergency Medicine, Tan Tock Seng Hospital, SingaporeDepartment of Preventive and Population Medicine, Office of Clinical Epidemiology, Analytics, and Knowledge [OCEAN], Tan Tock Seng Hospital, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore; Corresponding author. Mailing address: Department of Population and Preventive Medicine, Office of Clinical Epidemiology, Analytics, and Knowledge, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore.ABSTRACT: Objectives: Pre-COVID-19 pandemic, patients who attended the emergency department (ED) for upper respiratory tract infection (URTI) were more likely to receive antibiotics if they expected them. These expectations could have changed with the change in health-seeking behaviour during the pandemic. We assessed the factors associated with antibiotics expectation and receipt for uncomplicated URTI patients in four Singapore EDs during the COVID-19 pandemic. Methods: We conducted a cross-sectional study on adult patients with URTI from March 2021 to March 2022 in four Singapore EDs and assessed the determinants of antibiotics expectation and receipt using multivariable logistic regression models. We also assessed the reasons patients expect antibiotics during their ED visit. Results: Among 681 patients, 31.0% expected antibiotics while 8.7% received antibiotics during their ED visit. Factors (adjusted odds ratio [95% confidence interval]) that significantly influenced expectation for antibiotics include: 1) prior consultation for current illness with (6.56 [3.30–13.11]) or without (1.50 [1.01–2.23]) antibiotics prescribed; 2) anticipation for COVID-19 test (1.56 [1.01–2.41]); and 3) poor (2.16 [1.26–3.68]) to moderate (2.26 [1.33–3.84]) knowledge on antibiotics use and resistance. Patients expecting antibiotics were 10.6 times (10.64 [5.34–21.17]) more likely to receive antibiotics. Those with tertiary education were twice (2.20 [1.09–4.43]) as likely to receive antibiotics. Conclusion: In conclusion, patients with URTI who expected antibiotics to be prescribed remained more likely to receive it during the COVID-19 pandemic. This highlights the need for more public education on the non-necessity for antibiotics for URTI and COVID-19 to address the problem of antibiotic resistance.http://www.sciencedirect.com/science/article/pii/S2213716523000401Antimicrobial resistanceAntibiotics expectationEmergency departmentCOVID-19 |
| spellingShingle | Zhilian Huang Win Sen Kuan Hann Yee Tan Eillyne Seow Ling Tiah Li Lee Peng Yanyi Weng Angela Chow Antibiotic expectation, behaviour, and receipt among patients presenting to emergency departments with uncomplicated upper respiratory tract infection during the COVID-19 pandemic Journal of Global Antimicrobial Resistance Antimicrobial resistance Antibiotics expectation Emergency department COVID-19 |
| title | Antibiotic expectation, behaviour, and receipt among patients presenting to emergency departments with uncomplicated upper respiratory tract infection during the COVID-19 pandemic |
| title_full | Antibiotic expectation, behaviour, and receipt among patients presenting to emergency departments with uncomplicated upper respiratory tract infection during the COVID-19 pandemic |
| title_fullStr | Antibiotic expectation, behaviour, and receipt among patients presenting to emergency departments with uncomplicated upper respiratory tract infection during the COVID-19 pandemic |
| title_full_unstemmed | Antibiotic expectation, behaviour, and receipt among patients presenting to emergency departments with uncomplicated upper respiratory tract infection during the COVID-19 pandemic |
| title_short | Antibiotic expectation, behaviour, and receipt among patients presenting to emergency departments with uncomplicated upper respiratory tract infection during the COVID-19 pandemic |
| title_sort | antibiotic expectation behaviour and receipt among patients presenting to emergency departments with uncomplicated upper respiratory tract infection during the covid 19 pandemic |
| topic | Antimicrobial resistance Antibiotics expectation Emergency department COVID-19 |
| url | http://www.sciencedirect.com/science/article/pii/S2213716523000401 |
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