News Scan for Dec 02, 2020

Antibiotic prescribing during UK lockdown
Meningococcus B vaccine efficacy

Higher-than-expected antibiotic prescribing during UK COVID lockdown

Telephone consultations could be the reason why antibiotic prescribing at general practices in the United Kingdom was higher than expected during the first COVID-19 lockdown, researchers with the University of Nottingham reported yesterday in the Lancet Infectious Diseases.

Examination of National Health Service data from Apr 1 to Aug 31 showed that while the number of face-to-face appointments fell by 51.5% compared with the corresponding period in 2019, telephone consultations increased by 270.5%. The absolute number of appointments was 20.8% lower than in the corresponding period in 2019.

Based on the reduction in the absolute number of appointments, the researchers determined that the 15.5% decrease in antibiotic prescribing in 2020 was still 6.7% higher than expected. They suggest this finding indicates antibiotic prescribing rates are higher in remote consultations than during in-person consultations.

"This increase could reflect the greater diagnostic uncertainty that results from an inability to examine patients and perform investigations during telephone appointments, which might lead clinicians to take greater precautions in cases of possible infection," the authors wrote.

The authors also said that with telephone consultation volumes remaining high during the pandemic, clinicians need support to use antibiotics appropriately.
Dec 1 Lancet Infect Dis correspondence


Meningococcus vaccine Bexsero found 79% effective in youth

The 4CMenB vaccine, or Bexsero, is 79% effective in children, according to a study published yesterday in JAMA. In a matched case-control study, researchers looked at the health records of 98 youth who had lab-confirmed meningococcus—82 of whom had group B meningococcal disease—and 201 controls who did not have meningococcal disease.

While 70.4% of the children with group B meningococcus were old enough to have been fully immunized, only 7% had received the correct amount of vaccine dosages, compared with 23% of the control patients. No related disabilities occurred in ill children who received at least one vaccine dosage (11.2% of the 98 patients), but of those who did not receive vaccinations, 7 died and 16 suffered long-term injuries.

Cases were identified from October 2014 to March 2019 across 31 pediatric hospitals in Portugal, and each was matched with up to three control cases similar in demographics. The researchers noted they found similar vaccine efficacy results when looking at non-group B meningococcal strains.

"Although rare, meningococcus group B infection can become life-threatening within hours and can cause long-term disabilities," said senior author Adam Finn, PhD, in a University of Bristol news release. "Young children in particular are more at risk and may die or be seriously harmed even with top quality hospital treatment."

Bexsero, which is manufactured by Novartis, has been approved for use in Europe since 2013 and in the United States since 2015.
Dec 1 JAMA study
Dec 1 University of Bristol press release

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