Correction: Prevalence of bacterial coinfection and patterns of antibiotics prescribing in patients with COVID-19: A systematic review and meta-analysis.

[This corrects the article DOI: 10.1371/journal.pone.0272375.].

Attitudes of Gastroenterologists Regarding Delivery of Cancer Diagnoses: a Cross-Sectional Study.

GOALS: To determine the attitudes and practices of gastroenterologists regarding the delivery of cancer diagnoses. BACKGROUND: Gastroenterologists frequently diagnose colorectal cancer. Receiving the news of a cancer diagnosis is difficult, and the delivery of the diagnosis can influence a patient's understanding of their disease. No study to date has reported how gastroenterologists deliver cancer diagnoses to their patients. STUDY: An anonymous questionnaire was sent online to gastroenterologists of the American College of Gastroenterology to assess views regarding the delivery of cancer diagnoses. RESULTS: Of the 280 complete responses (response rate = 1.64%), most respondents were male (n = 205, 73.21%), in practice between 0 and 9 years (n = 133, 47.50%), and at the attending/faculty level (n = 69.53%, 194). Most responded that they would disclose a cancer diagnosis to the patient themselves if they had made the discovery on endoscopy/colonoscopy (n = 255, 94.80%), with the preferred methods being an in person discussion (n = 187, 71.65%). Most respondents were not familiar with any guidelines for delivering cancer diagnoses (n = 202, 75.94%) and would be open to receiving training on cancer diagnosis delivery (n = 207, 78.11%). CONCLUSIONS: Most gastroenterologists take personal responsibility in the delivery of cancer diagnoses. Many gastroenterologists receive no specific training on how to deliver this news and are unaware of any guidelines to follow that may be helpful in their practice. However, most displayed a willingness to learn these guidelines through some form of formal education. Future directions should consider the incorporation of education in cancer diagnosis delivery for gastroenterologists and gastroenterology fellows.

Prevalence of bacterial coinfection and patterns of antibiotics prescribing in patients with COVID-19: A systematic review and meta-analysis.

BACKGROUND: Evidence around prevalence of bacterial coinfection and pattern of antibiotic use in COVID-19 is controversial although high prevalence rates of bacterial coinfection have been reported in previous similar global viral respiratory pandemics. Early data on the prevalence of antibiotic prescribing in COVID-19 indicates conflicting low and high prevalence of antibiotic prescribing which challenges antimicrobial stewardship programmes and increases risk of antimicrobial resistance (AMR). AIM: To determine current prevalence of bacterial coinfection and antibiotic prescribing in COVID-19 patients. DATA SOURCE: OVID MEDLINE, OVID EMBASE, Cochrane and MedRxiv between January 2020 and June 2021. STUDY ELIGIBILITY: English language studies of laboratory-confirmed COVID-19 patients which reported (a) prevalence of bacterial coinfection and/or (b) prevalence of antibiotic prescribing with no restrictions to study designs or healthcare setting. PARTICIPANTS: Adults (aged ≥ 18 years) with RT-PCR confirmed diagnosis of COVID-19, regardless of study setting. METHODS: Systematic review and meta-analysis. Proportion (prevalence) data was pooled using random effects meta-analysis approach; and stratified based on region and study design. RESULTS: A total of 1058 studies were screened, of which 22, hospital-based studies were eligible, compromising 76,176 of COVID-19 patients. Pooled estimates for the prevalence of bacterial co-infection and antibiotic use were 5.62% (95% CI 2.26-10.31) and 61.77% (CI 50.95-70.90), respectively. Sub-group analysis by region demonstrated that bacterial co-infection was more prevalent in North American studies (7.89%, 95% CI 3.30-14.18). CONCLUSION: Prevalence of bacterial coinfection in COVID-19 is low, yet prevalence of antibiotic prescribing is high, indicating the need for targeted COVID-19 antimicrobial stewardship initiatives to reduce the global threat of AMR.

The impact of the COVID-19 pandemic lockdown measures on the prescribing trends and utilization of opioids in the English primary care setting: segmented-liner regression analysis.

BACKGROUND: The COVID-19 lockdown has resulted in limited access to most of the conventional chronic pain management services. Subsequently, changes in opioids' utilization could be expected. This study assessed the impact of the first COVID-19 lockdown on opioid utilization using aggregated-level, community dispensing dataset covering the whole English population. RESEARCH DESIGN AND METHODS: A segmented-linear regression analysis was applied to monthly dispensed opioid prescriptions from March 2019 to March 2021. Opioid utilization was measured using the number of opioids' items dispensed/1000 inhabitants and Defined Daily Dose (DDD)/1000 inhabitants/day during 12-months pre/post the lockdown in March 2020 stratified by strong and weak opioids. RESULTS: For all opioids' classes, there were nonsignificant changes in the number of opioids' items dispensed/1000 inhabitants trend pre-lockdown, small increases in their level immediately post-lockdown, and a non-significant decline in the trend post-lockdown. Similarly, a non-significant reduction in the DDD/1000 inhabitant/day baseline trend pre-lockdown, nonsignificant immediate increases in the level post-lockdown, and declines in the trend post-lockdown for all opioids' classes were observed. CONCLUSION: Unexpectedly, opioid utilization does not appear to have been significantly affected by the lockdown measures during the study period. However, patient-level data is needed to determine more accurate estimates of any changes in the opioid prescribing including incident prescribing/use.