Search

Testing serum C‐reactive protein (CRP) levels can help determine whether there is a need for antibiotics and can limit prescribing of antibiotics for illnesses that are likely viral or non‐infectious in origin. Using Health Search, an Italian primary care database, we identified all patients, aged 15 years or older, being registered in the period between 1 January 2000 and 31 December 2019 and newly diagnosed with upper respiratory tract infections (URTIs) or COPD‐ or asthma‐related exacerbations. From the date of these diagnoses, patients were followed up until occurrence of antibiotic prescription (for these indications) up to 31 December 2019. The association between the CRP testing and the outcome was investigated using a nested case–control analysis. In a cohort of 469 684 patients being diagnosed for URTI (83%), COPD‐ (11%) and asthma (7%)‐related exacerbations, 28 688 (6.11%) were prescribed with antibiotics because of the aforementioned indications. Of note, 98% of cases, nominally those prescribed with antibiotics, were not tested with CRP. However, those receiving antibiotics were more likely to have been previously tested for CRP than controls who did not receive antibiotics (833/28 601 [3%] and 4128/277 968 [1.5%]; OR 2.0 [95% CI: 1.8–2.1]). Our findings indicate that most of the antibiotic prescriptions for the investigated conditions were given without any prior CRP testing. A small minority of GPs did properly use CRP to determine whether antibiotics were needed. Further guidance is needed in Italy on the use of CRP in guiding antibiotic prescribing in primary care. [ABSTRACT FROM AUTHOR]

Annual influenza vaccination is one of the main public health measures able to drastically reduce the burden of this infectious disease. Some evidence suggests 'trained immunity' triggered by influenza vaccine might reduce the risk of SARS‐CoV‐2 infection. Adjuvanted influenza vaccines are known to induce a broader cross‐reactive immunity. No studies investigated the effect of adjuvanted vs. non‐adjuvanted influenza vaccines on the risk of symptomatic SARS‐CoV‐2 infection. A case–control analysis nested in a cohort of subjects aged ≥65 years and immunized with adjuvanted or non‐adjuvanted influenza vaccines was conducted. Although no statistically significant (OR = 0.87; P =.082) difference between the two vaccine types was observed for the 9‐month follow‐up period, a 17% (OR = 0.83; P =.042) reduction in the odds of COVID‐19 was observed for adjuvanted vaccines with a 6‐month follow‐up. Further evidence is needed, but these results might have implications given the complexity of the upcoming winter seasons, in which the co‐occurrence of influenza, SARS‐CoV‐2 and other respiratory infections (e.g., syncytial virus) might be unpredictable. [ABSTRACT FROM AUTHOR]