Abstract Body

Objectives

To assess the impact of the COVID-19 pandemic on: 1) Primary health care, including antibiotic prescribing, for patients contacting their GP with symptoms of a respiratory tract infection (RTI) in Europe; 2) Presentation for infectious diseases and antibiotic prescribing in the Netherlands.

Setting, design and participants

1) Prospective observational audit in primary care in 16 countries before (Jan-Feb) and early in the pandemic (March-May 2020); 2) Patients included in a routine health care database (March-May 2019 and March-May 2020).

Outcome measures

1) Various registered management characteristics and GPs’ confidence in management; 2) Disease episodes and antibiotic prescribing for RTI/ear, urinary tract, gastrointestinal and skin infections. Differences between pandemic and pre-pandemic care are described.

Results

1) Patient management with respect to measurements, diagnostic testing, advice provided and referral varied considerably between countries, as did the proportion of patients prescribed antibiotics (Belgium 3%-UK 48%). Antibiotic prescribing was lower during the pandemic compared to the months before, except for Greece, Poland and UK. Antibiotic prescribing for patients suspected of COVID-19 was low. 2) Fewer episodes were observed in the first pandemic wave than in the same months in 2019 for all four infectious disease entities. The antibiotic prescription rate for RTI declined as well. There was no evidence of an increase in complications like pneumonia, mastoiditis and pyelonephritis.

Conclusions

The COVID-19 pandemic has had profound effects on the presentation of infectious disease episodes and antibiotic use. Despite large between-country variation in care, GPs reported a high degree of confidence in managing their patients with RTIs in the emerging pandemic.