{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T22:05:52Z","timestamp":1792188352425,"version":"4.4.0"},"reference-count":30,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,3,14]],"date-time":"2023-03-14T00:00:00Z","timestamp":1678752000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Innovative Medicine Initiative 2 Joint Undertaking","award":["820755"],"award-info":[{"award-number":["820755"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Up to 80% of antibiotics are prescribed in the community. An assessment of prescribing by indication will help to identify areas where improvement can be made. A point prevalence audit study (PPAS) of consecutive respiratory tract infection (RTI) consultations in general practices in 13 European countries was conducted in January\u2013February 2020 (PPAS-1) and again in 2022 (PPAS-4). The European Surveillance of Antibiotic Consumption quality indicators (ESAC-QI) were calculated to identify where improvements can be made. A total of 3618 consultations were recorded for PPAS-1 and 2655 in PPAS-4. Bacterial aetiology was suspected in 26% (PPAS-1) and 12% (PPAS-4), and an antibiotic was prescribed in 30% (PPAS-1) and 16% (PPAS-4) of consultations. The percentage of adult patients with bronchitis who receive an antibiotic should, according to the ESAC-QI, not exceed 30%, which was not met by participating practices in any country except Denmark and Spain. For patients (\u22651) with acute upper RTI, less than 20% should be prescribed an antibiotic, which was achieved by general practices in most countries, except Ireland (both PPAS), Croatia (PPAS-1), and Greece (PPAS-4) where prescribing for acute or chronic sinusitis (0\u201320%) was also exceeded. For pneumonia in adults, prescribing is acceptable for 90\u2013100%, and this is lower in most countries. Prescribing for tonsillitis (\u22651) exceeded the ESAC-QI (0\u201320%) in all countries and was 69% (PPAS-1) and 75% (PPAS-4). In conclusion, ESAC-QI applied to PPAS outcomes allows us to evaluate appropriate antibiotic prescribing by indication and benchmark general practices and countries.<\/jats:p>","DOI":"10.3390\/antibiotics12030572","type":"journal-article","created":{"date-parts":[[2023,3,14]],"date-time":"2023-03-14T06:14:58Z","timestamp":1678774498000},"page":"572","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Disease-Specific Quality Indicators for Outpatient Antibiotic Prescribing for Respiratory Infections (ESAC Quality Indicators) Applied to Point Prevalence Audit Surveys in General Practices in 13 European Countries"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6583-4300","authenticated-orcid":false,"given":"Akke","family":"Vellinga","sequence":"first","affiliation":[{"name":"School of Public Health, Physiotherapy and Sports Science, University College Dublin, D04 V1W8 Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Addiena","family":"Luke-Currier","sequence":"additional","affiliation":[{"name":"School of Public Health, Physiotherapy and Sports Science, University College Dublin, D04 V1W8 Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6181-8154","authenticated-orcid":false,"given":"Nathaly","family":"Garz\u00f3n-Orjuela","sequence":"additional","affiliation":[{"name":"School of Public Health, Physiotherapy and Sports Science, University College Dublin, D04 V1W8 Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rune","family":"Aabenhus","sequence":"additional","affiliation":[{"name":"Research Unit for General Practice, Department of Public Health, University of Copenhagen, DK-2200 Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marilena","family":"Anastasaki","sequence":"additional","affiliation":[{"name":"Department of Social Medicine, School of Medicine, University of Crete, 71003 Heraklion, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anca","family":"Balan","sequence":"additional","affiliation":[{"name":"Balan Medfam Srl, 400064 Cluj Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Femke","family":"B\u00f6hmer","sequence":"additional","affiliation":[{"name":"Institute of General Practice, Rostock University Medical Center, 18057 Rostock, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerija Brali\u0107","family":"Lang","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, \u201cAndrija Stampar\u201d School of Public Health, School of Medicine, University of Zagreb, 10020 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Slawomir","family":"Chlabicz","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Medical University of Bialystok, 15-089 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1238-8052","authenticated-orcid":false,"given":"Samuel","family":"Coenen","sequence":"additional","affiliation":[{"name":"Department of Family Medicine & Population Health, University of Antwerp, 2610 Antwerp, Belgium"},{"name":"Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute, University of Antwerp, 2610 Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6689-6466","authenticated-orcid":false,"given":"Ana","family":"Garc\u00eda-Sangen\u00eds","sequence":"additional","affiliation":[{"name":"Institut Universitari d\u2019Investigaci\u00f3 en Atenci\u00f3 Prim\u00e0ria Jordi Gol (IDIAP Jordi Gol), 08007 Barcelona, Spain"},{"name":"Centro de investigaci\u00f3n Biom\u00e9dica en Red Enfermedades Infecciosas (CIBERINFEC), 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7524-2085","authenticated-orcid":false,"given":"Anna","family":"Kowalczyk","sequence":"additional","affiliation":[{"name":"Centre for Family and Community Medicine, Faculty of Health Sciences, Medical University of Lodz, 92-213 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lile","family":"Malania","sequence":"additional","affiliation":[{"name":"National Center for Disease Control and Public Health, Tbilisi and Arner Science Management LLC, 0190 Tbilisi, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Tomacinschii","sequence":"additional","affiliation":[{"name":"University Clinic of Primary Medical Assistance, State University of Medicine and Pharmacy \u201cNicolae Testemi\u021banu\u201d, MD-2004 Chi\u015fin\u01ceu, Moldova"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanne R.","family":"van der Linde","sequence":"additional","affiliation":[{"name":"Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Universiteitsweg 100, 3584 CG Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Bongard","sequence":"additional","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX1 4BH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0102-3453","authenticated-orcid":false,"given":"Christopher C.","family":"Butler","sequence":"additional","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX1 4BH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herman","family":"Goossens","sequence":"additional","affiliation":[{"name":"Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute, University of Antwerp, 2610 Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alike W.","family":"van der Velden","sequence":"additional","affiliation":[{"name":"Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Universiteitsweg 100, 3584 CG Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,14]]},"reference":[{"key":"ref_1","unstructured":"WHO Regional Office for Europe\/European Centre for Disease Prevention and Control (2022). 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