Abstract
Presentation and antibiotic prescribing for common infectious disease episodes decreased substantially during the first COVID-19 pandemic wave in Dutch general practice. We set out to determine the course of these variables during the first pandemic year. We conducted a retrospective observational cohort study using routine health care data from the Julius General Practitioners’ Network. All patients registered in the pre-pandemic year (n = 425,129) and/or during the first pandemic year (n = 432,122) were included. Relative risks for the number of infectious disease episodes (respiratory tract/ear, urinary tract, gastrointestinal, and skin), in total and those treated with antibiotics, and proportions of episodes treated with antibiotics (prescription rates) were calculated. Compared to the pre-pandemic year, primary care presentation for common infections remained lower during the full first pandemic year (RR, 0.77; CI, 0.76–0.78), mainly attributed to a sustained decline in respiratory tract/ear and gastrointestinal infection episodes. Presentation for urinary tract and skin infection episodes declined during the first wave, but returned to pre-pandemic levels during the second and start of the third wave. Antibiotic prescription rates were lower during the full first pandemic year (24%) as compared to the pre-pandemic year (28%), mainly attributed to a 10% lower prescription rate for respiratory tract/ear infections; the latter was not accompanied by an increase in complications. The decline in primary care presentation for common infections during the full first COVID-19 pandemic year, together with lower prescription rates for respiratory tract/ear infections, resulted in a substantial reduction in antibiotic prescribing in Dutch primary care.
Highlights
The WHO declared COVID-19 a global pandemic in March 2020 [1], with three consecutive pandemic waves in the Netherlands, the first of which lasted from March 2020 through May 2020
After the first wave of the pandemic, we evaluated primary care presentation and antibiotic prescribing for common infection episodes in the Netherlands, and found a sharp decrease in respiratory and ear infections, with a concomitant decrease in antibiotic use [8]
The total numbers of consultations for common infections were 209,698 pre-pandemic, and 172,218 during the first pandemic year, which respectively related to 136,009 and 105,619 infectious disease episodes
Summary
The WHO declared COVID-19 a global pandemic in March 2020 [1], with three consecutive pandemic waves in the Netherlands, the first of which lasted from March 2020 through May 2020. In October 2020, the number of SARS-CoV-2 infections rose again, marking the start of the second wave, which consisted of two parts: a first peak (October and November 2020), and a second peak (December 2020 and January 2021). Nationwide infection control measures [3] were first introduced in March 2020, during the ‘intelligent’ lockdown of the Netherlands, which ended in June 2020. Restaurants, bars, theatres, ‘contact’ professions (e.g., hairdressers), and sport facilities were closed, and visits to nursing homes were not allowed. During the first part of the second wave, a ‘partial’ lockdown was introduced in October, allowing schools and sports facilities to remain open, but restricting group sizes outside and at home. During the second part of the second wave, The Netherlands went into a ‘strict’ lockdown in December 2020, which included the closure of schools and non-essential shops, and a curfew. Wearing non-medical facemasks was obligatory in indoor public spaces
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