From the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
The Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer-Sheva, Israel.
Pediatr Infect Dis J. 2022 Aug 1;41(8):636-641. doi: 10.1097/INF.0000000000003570. Epub 2022 Jul 13.
The proportion of remote clinic visits was expected to increase among children during the COVID-19 pandemic which might result in antibiotic overuse.
In southern Israel, 2 ethnic groups, Jewish and Bedouin, live side-by-side. Computerized data on visits for children <18 years were examined from clinics with ≥50 insured children, active both pre-COVID-19 and during the COVID-19 pandemic. Visits were divided into in-person and remote. Monthly infectious diagnoses and dispensed antibiotic prescription rates were calculated by age (<5, 5-17 years) and ethnic groups. Mean monthly rates of 2 parallel seasons (pre-COVID-19 and COVID-19 periods) were compared.
Overall 2,120,253 outpatient clinic visits were recorded. Remote clinic visit rates (per 1000 children) increased from 97.04 and 33.86 in the pre-COVID-19 to 179.75 and 50.05 in the COVID-19 period in Jewish and Bedouin children, respectively ( P < 0.01) along with a reduction of in-person visit rates in both populations. Comparing pre-COVID-19 and COVID-19 periods, the rates of overall infectious diagnoses in remote visits increased. Nevertheless, dispensed antibiotic prescription rates in remote visits (per 1000 visits) remained unchanged (9.84 vs. 8.67, P = 0.70, in the Jewish population and 14.32 vs. 14.17, P = 1.00, in the Bedouin population in the pre-COVID-19 and COVID-19 periods, respectively) with a similar distribution of antibiotic categories.
COVID-19 pandemic resulted in an expansion of remote visits of children <18 years with an increase in infectious diagnoses. However, remote dispensed antibiotic prescription rates remained unchanged. These dynamics were more accentuated in Jewish children, characterized by higher socio-economic conditions, compared to Bedouin children.
预计在 COVID-19 大流行期间，儿童远程诊所就诊的比例将会增加，这可能导致抗生素的过度使用。
在以色列南部，犹太人和贝都因人两个民族毗邻而居。对在 COVID-19 大流行之前和大流行期间均有活动、至少有 50 名参保儿童的诊所进行了儿童（<18 岁）就诊的计算机数据检查。就诊分为面对面和远程两种方式。按年龄（<5 岁、5-17 岁）和民族计算每月传染性诊断和配给抗生素处方率。比较了两个平行季节（COVID-19 大流行之前和期间）的每月平均率。
共记录了 2120253 例门诊诊所就诊。远程诊所就诊率（每千名儿童）从 COVID-19 大流行之前的 97.04 和 33.86 分别增加到犹太儿童和贝都因儿童的 179.75 和 50.05（P<0.01），同时这两个群体的面对面就诊率均有所下降。与 COVID-19 大流行之前相比，远程就诊的总体传染性诊断率增加。然而，远程就诊的抗生素处方率（每千次就诊）保持不变（犹太人群中分别为 9.84 与 8.67，P=0.70；贝都因人群中分别为 14.32 与 14.17，P=1.00），抗生素类别分布相似。
COVID-19 大流行导致 18 岁以下儿童远程就诊的增加，传染性诊断也有所增加。然而，远程配给的抗生素处方率保持不变。与贝都因人相比，在社会经济条件较高的犹太儿童中，这种动态更为明显。
