Hullegie Saskia, Schilder Anne G M, Marchisio Paola, de Sévaux Joline L H, van der Velden Alike W, van de Pol Alma C, Boeijen Josi A, Platteel Tamara N, Torretta Sara, Damoiseaux Roger A M J, Venekamp Roderick P
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.
evidENT, Ear Institute, University College London, London, United Kingdom.
Front Cell Infect Microbiol. 2021 Nov 1;11:768377. doi: 10.3389/fcimb.2021.768377. eCollection 2021.
Recent reports have highlighted the impact of the COVID-19 pandemic on the incidence of infectious disease illnesses and antibiotic use. This study investigates the effect of the pandemic on childhood incidence of otitis media (OM) and associated antibiotic prescribing in a large primary care-based cohort in the Netherlands.
Retrospective observational cohort study using routine health care data from the Julius General Practitioners' Network (JGPN). All children aged 0-12 registered in 62 practices before the COVID-19 pandemic (1 March 2019 - 29 February 2020) and/or during the pandemic (1 March 2020 - 28 February 2021) were included. Data on acute otitis media (AOM), otitis media with effusion (OME), ear discharge episodes and associated antibiotic prescriptions were extracted. Incidence rates per 1,000 child years (IR), incidence rate ratios (IRR) and incidence rate differences (IRD) were compared between the two study periods.
OM episodes declined considerably during the COVID-19 pandemic: IR pre-COVID-19 vs COVID-19 for AOM 73.7 vs 27.1 [IRR 0.37]; for OME 9.6 vs 4.1 [IRR 0.43]; and for ear discharge 12.6 vs 5.8 [IRR 0.46]. The absolute number of AOM episodes in which oral antibiotics were prescribed declined accordingly (IRD pre-COVID-19 vs COVID-19: -22.4 per 1,000 child years), but the proportion of AOM episodes with antibiotic prescription was similar in both periods (47% vs 46%, respectively).
GP consultation for AOM, OME and ear discharge declined by 63%, 57% and 54% respectively in the Netherlands during the COVID-19 pandemic. Similar antibiotic prescription rates before and during the pandemic indicate that the case-mix presenting to primary care did not considerably change. Our data therefore suggest a true decline as a consequence of infection control measures introduced during the pandemic.
近期报告强调了新冠疫情对传染病发病率及抗生素使用的影响。本研究调查了疫情对荷兰一个大型基层医疗队列中儿童中耳炎（OM）发病率及相关抗生素处方的影响。
采用来自朱利叶斯全科医生网络（JGPN）的常规医疗数据进行回顾性观察队列研究。纳入所有在新冠疫情前（2019年3月1日至2020年2月29日）和/或疫情期间（2020年3月1日至2021年2月28日）在62家诊所登记的0至12岁儿童。提取急性中耳炎（AOM）、中耳积液（OME）、耳部流脓发作及相关抗生素处方的数据。比较两个研究期间每1000儿童年的发病率（IR）、发病率比（IRR）和发病率差异（IRD）。
在新冠疫情期间，中耳炎发作显著减少：新冠疫情前与疫情期间AOM的IR分别为73.7和27.1 [IRR 0.37]；OME的IR分别为9.6和4.1 [IRR 0.43]；耳部流脓的IR分别为12.6和5.8 [IRR 0.46]。开具口服抗生素的AOM发作绝对数量相应下降（新冠疫情前与疫情期间的IRD：每1000儿童年 -22.4），但两个时期AOM发作使用抗生素处方的比例相似（分别为47%和46%）。
在荷兰，新冠疫情期间因AOM、OME和耳部流脓进行的全科医生诊疗分别下降了63%、57%和54%。疫情前和疫情期间相似的抗生素处方率表明，到基层医疗就诊的病例组合没有显著变化。因此，我们的数据表明，疫情期间采取的感染控制措施导致了实际下降。
