12th December 2023: Public PhD defence of Sara Debes Burdens of viral respiratory infection and consumption of antibiotics in Østfold, Norway
Congratulations to Sara Debes at her public PhD defense which took place 12th December 2023 at the University of Oslo!
She was enrolled in the PhD programme at the Institute of Clinical Medicine at Faculty of Medicine, University of Oslo with main supervisor Susanne Dudman as part of a collaboration project with co-supervisors Christine Jonassen and Jon Birger Haug at Sykehuset Østfold and Birgitte de Blasio at Norwegian Institute of Public Health.
Her project consisted of three studies on respiratory virus infections. Respiratory infections are common, and adults experience one or more infections yearly. Most of the infections are viral, yet the amount of antibiotics prescribed to these patients is considerable. This is of great concern, in the light of the antimicrobial resistance crisis. The aims of this thesis were to investigate the etiology, severity, outcome and antibiotic consumption in hospitalized adults with viral respiratory infection. We designed a retrospective observational study, investigating adults hospitalized with viral respiratory infections in Østfold Hospital Trust.
We found a seasonal variation, with human metapneumovirus being the most common in 2015-16, influenza A in 2016-17, and finally, influenza B in 2017-18. Prior to hospitalization, 20% of the patients received antibiotic treatment. Patients with Respiratory Syncytial Virus (RSV) received prehospitalization antibiotic treatment more often (28%) than other patients. The patients hospitalized with RSV constituted 15% of the patients, with higher National Early Warning Score (NEWS) of severity of disease, and higher inflammatory markers, than patients admitted with influenza A. Furthermore, comorbidities like COPD and congestive heart failure were more frequent in this patient group. During hospitalization, 76% of the patients with viral respiratory infection received antibiotic treatment, despite no microbiological evidence of bacterial infection. Furthermore, 40% of these patients received an antibiotic agent in the WHO AWaRe Watch category, consisting of antibiotic agents with higher resistance driving potential. Antibiotic treatment prolonged the hospital stay, also when adjusted for age, gender and comorbidities, but was not associated with reduced mortality.
This thesis has shed light on the causes of viral respiratory infections in adults admitted to hospital and the associated disease burden, emphasizing the need for enhanced antibiotic stewardship and specific interventions, such as vaccination.
Burdens of viral respiratory infection and consumption of antibiotics in Østfold, Norway (med.uio.no)