Physicians' irrational attitudes on the antibiotic prescribing for the treatment of COVID-19 in Turkey: A multicenter survey.

BACKGROUND: The inappropriate and excessive use of antibiotics during the coronavirus pandemic has become an important issue. OBJECTIVE: Our primary aim is to ascertain the attitudes of physicians toward the antibiotics prescribing for the treatment of COVID-19 in Turkey. Our secondary aim was to identify factors affecting to physicians' decisions regarding antibiotic therapy for the treatment of COVID-19 and risk factors associated with antibiotic overprescribing. METHODS: It was a multicenter cross-sectional survey. Physicians from 63 different cities were invited to survey through social media (Facebook, Instagram, WhatsApp). Data were collected from respondents through an online questionnaires during November-December 2021. RESULTS: The survey was completed by 571 participants from 63 cities. Pulmonologists comprised the majority (35.20%), followed by internal medical specialists (27.85%) and general practitioners (23.29%). The rates of participants who started empirical antibiotics in the outpatient, ward, and ICU (intensive care unit) were 70.2%, 85.5%, and 74.6%, respectively. When the practice of prescribing antibiotics by physicians for the treatment of COVID-19 in outpatients was compared according to the healthcare setting (primary, secondary, tertiary care hospitals) no significant difference was found. Sputum purulence (68.2%) was recognized as the most important factor for the decision of antibiotic therapy, followed by procalcitonin levels (64.9%) and abnormal radiological findings (50.3%). The most prescribed antibiotics were respiratory quinolones. (48%, 65.9%, 62.7% outpatient, ward, ICU respectively) CONCLUSIONS: In this study, we found that physicians frequently had irrational attitudes toward antibiotic prescription to COVID-19 patients, including those with minor diseases. Our findings underline that the necessity of particular, workable interventions to guarantee the prudent use of antibiotics in COVID-19.

Correlation Between Daily PM10, Nitrogen Dioxide, and Ozone Measurements with the Stringency Index in 15 Different Districts of a Big Metropolis.

OBJECTIVE: Studies have investigated the effects of lockdowns on air quality around the world and found that fine particulate matter and nitrogen dioxide concentrations decreased due to reduced human activity, while ozone concentrations increased. In this study, we aimed to evaluate the correlation between daily stringency index values of our country and daily PM10, nitrogen dioxide, and ozone measurements in different districts of Istanbul between March 1, 2020, and February 28, 2022. MATERIAL AND METHODS: Ministry of Environment and Urbanization and National Air Quality Monitoring Network data on Istanbul air quality monitoring stations were used. The analysis included 15 stations that can monitor at least 75% of the days in a year. PM10, nitrogen dioxide, and ozone were the main pollutants analyzed. RESULTS: There was negative correlation between daily PM10 measurements and daily stringency index values in 3 stations; there was positive correlation in 6 stations. Between daily stringency index values and daily nitrogen dioxide measurements, there was a negative correlation in 3 stations and a positive correlation in 1 station. The daily measurements of 1 station showed a negative correlation with the daily values of stringency index for both PM10 and nitrogen dioxide. In 1 station, while PM10 measures were negatively correlated with stringency index, nitrogen dioxide measurements were positively correlated. CONCLUSION: This study showed that pandemic limitations could not improve Istanbul's air quality everywhere. For adequate evaluation of impact of the limitations on air quality, it may be more relevant to study the socioeconomic infrastructure of each living area, the sociospatial inequality, industrial employment, the number of households, the density of employee class, and so on with all influencing factors that could have contributed to these various changes.