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1. A survey study on antibiotic prescription practices for acute asthma exacerbations:An European academy of allergy and clinical immunology task force report

Author

Redel, Anne Lotte, Feleszko, Wojciech, Arcolaci, Alessandra, Cefaloni, Francesca, Atanaskovic-Markovic, Marina, Braunstahl, Gert Jan, Boccabella, Cristina, Bonini, Matteo, Karavelia, Aspasia, Louwers, Eefje, Mülleneisen, Norbert, O'Mahony, Liam, Pini, Laura, Rapiejko, Anna, Shehu, Esmeralda, Sokolowska, Milena, Untersmayr, Eva, Tramper-Stranders, Gerdien, Redel, Anne Lotte, Feleszko, Wojciech, Arcolaci, Alessandra, Cefaloni, Francesca, Atanaskovic-Markovic, Marina, Braunstahl, Gert Jan, Boccabella, Cristina, Bonini, Matteo, Karavelia, Aspasia, Louwers, Eefje, Mülleneisen, Norbert, O'Mahony, Liam, Pini, Laura, Rapiejko, Anna, Shehu, Esmeralda, Sokolowska, Milena, Untersmayr, Eva, and Tramper-Stranders, Gerdien

Abstract

Introduction: Guidelines recommend treating asthma exacerbations (AAEs) with bronchodilators combined with inhaled and/or systemic corticosteroids. Indications for antibiotic prescriptions for AAEs are usually not incorporated although the literature shows antibiotics are frequently prescribed. Aim: To investigate the antibiotic prescription rates in AAEs and explore the possible determining factors of those practices. Methods: A digital survey was created to determine the antibiotic prescription rates in AAEs and the influencing factors for the prescription practices. The survey was distributed among European academy of allergy and clinical immunology (EAACI) members by mass emailing and through regional/national societies in the Netherlands, Italy, Greece, and Poland. Furthermore, we retrieved local antibiotic prescription rates. Results: In total, 252 participants completed the survey. Respondents stated that there is a lack of guidelines to prescribe antibiotics in AAEs. The median antibiotic prescription rate in this study was 19% [IQR: 0%–40%] and was significantly different between 4 professions: paediatrics 0% [IQR: 0%–37%], pulmonologists 25% [IQR: 10%–50%], general practitioners 25% [IQR: 0%–50%], and allergologists 17% [IQR: 0%–33%]) (p = 0.046). Additional diagnostic tests were performed in 71.4% of patients before prescription and the most common antibiotic classes prescribed were macrolides (46.0%) and penicillin (42.9%). Important clinical factors for health care providers to prescribe antibiotics were colorised/purulent sputum, abnormal lung sounds during auscultation, fever, and presence of comorbidities. Conclusion:In 19% of patients with AAEs, antibiotics were prescribed in various classes with a broad range among different subspecialities. This study stresses the urgency to compose evidence-based guidelines to aim for more rational antibiotic pres

Published
2024

2. Management of patients with chronic rhinosinusitis during the COVID-19 pandemic-An EAACI position paper.

Author

UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, UCL - (SLuc) Service d'oto-rhino-laryngologie, Klimek, Ludger, Jutel, Marek, Bousquet, Jean, Agache, Ioana, Akdis, Cezmi A, Hox, Valérie, Gevaert, Philippe, Tomazic, Peter Valentin, Rondon, Carmen, Cingi, Cemal, Toppila-Salmi, Sanna, Karavelia, Aspasia, Bozkurt, Banu, Förster-Ruhrmann, Ulrike, Becker, Sven, Chaker, Adam M, Wollenberg, Barbara, Mösges, Ralph, Huppertz, Tilman, Hagemann, Jan, Bachert, Claus, Fokkens, Wytske, UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, UCL - (SLuc) Service d'oto-rhino-laryngologie, Klimek, Ludger, Jutel, Marek, Bousquet, Jean, Agache, Ioana, Akdis, Cezmi A, Hox, Valérie, Gevaert, Philippe, Tomazic, Peter Valentin, Rondon, Carmen, Cingi, Cemal, Toppila-Salmi, Sanna, Karavelia, Aspasia, Bozkurt, Banu, Förster-Ruhrmann, Ulrike, Becker, Sven, Chaker, Adam M, Wollenberg, Barbara, Mösges, Ralph, Huppertz, Tilman, Hagemann, Jan, Bachert, Claus, and Fokkens, Wytske

Abstract

BACKGROUND: Chronic rhinosinusitis is regarded as a chronic airway disease. According to WHO recommendations, it may be a risk factor for COVID-19 patients. In most CRSwNP cases, the inflammatory changes affecting the nasal and paranasal mucous membranes are type-2 (T2) inflammation endotypes. METHODS: The current knowledge on COVID-19 and on treatment options for CRS was analyzed by a literature search in Medline, Pubmed, international guidelines, the Cochrane Library and the Internet. RESULTS: Based on international literature, on current recommendations by WHO and other international organizations as well as on previous experience, a panel of experts from EAACI and ARIA provided recommendations for the treatment of CRS during the COVID-19 pandemic. CONCLUSION: Intranasal corticosteroids remain the standard treatment for CRS in patients with SARS-CoV-2 infection. Surgical treatments should be reduced to a minimum and surgery preserved for patients with local complications and for those with no other treatment options. Systemic corticosteroids should be avoided. Treatment with biologics can be continued with careful monitoring in noninfected patients and should be temporarily interrupted during the course of the COVID-19 infection.

Published
2021

3. Management of patients with chronic rhinosinusitis during the COVID‐19 pandemic – An EAACI Position Paper

Author

Klimek, L, Jutel, M, Bousquet, J, Agache, I; https://orcid.org/0000-0001-7994-364X, Akdis, Cezmi A; https://orcid.org/0000-0001-8020-019X, Hox, V, Gevaert, P, Tomazic, P V; https://orcid.org/0000-0001-6445-4800, Rondon, C; https://orcid.org/0000-0003-0976-3402, Cingi, C; https://orcid.org/0000-0003-3934-5092, Toppila‐Salmi, S; https://orcid.org/0000-0003-0890-6686, Karavelia, A, Bozkurt, B, Förster‐Ruhrmann, U; https://orcid.org/0000-0001-5059-5610, Becker, S, Chaker, Adam M, Wollenberg, B; https://orcid.org/0000-0002-3062-459X, Mösges, R; https://orcid.org/0000-0002-1928-810X, Huppertz, T, Hagemann, J; https://orcid.org/0000-0002-9846-7850, Bachert, C; https://orcid.org/0000-0003-4742-1665, Fokkens, W; https://orcid.org/0000-0003-4852-229X, Klimek, L, Jutel, M, Bousquet, J, Agache, I; https://orcid.org/0000-0001-7994-364X, Akdis, Cezmi A; https://orcid.org/0000-0001-8020-019X, Hox, V, Gevaert, P, Tomazic, P V; https://orcid.org/0000-0001-6445-4800, Rondon, C; https://orcid.org/0000-0003-0976-3402, Cingi, C; https://orcid.org/0000-0003-3934-5092, Toppila‐Salmi, S; https://orcid.org/0000-0003-0890-6686, Karavelia, A, Bozkurt, B, Förster‐Ruhrmann, U; https://orcid.org/0000-0001-5059-5610, Becker, S, Chaker, Adam M, Wollenberg, B; https://orcid.org/0000-0002-3062-459X, Mösges, R; https://orcid.org/0000-0002-1928-810X, Huppertz, T, Hagemann, J; https://orcid.org/0000-0002-9846-7850, Bachert, C; https://orcid.org/0000-0003-4742-1665, and Fokkens, W; https://orcid.org/0000-0003-4852-229X

Abstract

Background CRS is regarded as a chronic airway disease. According to WHO recommendations, it may be a risk factor for COVID‐19 patients. In most CRSwNP cases, the inflammatory changes affecting the nasal and paranasal mucous membranes are type‐2 (T2) inflammation endotypes. Methods The current knowledge on COVID‐19 and on treatment options for CRS was analyzed by a literature search in Medline, Pubmed, international guidelines, the Cochrane Library and the Internet. Results Based on international literature, on current recommendations by WHO and other international organizations as well as on previous experience, a panel of experts from EAACI and ARIA provided recommendations for the treatment of CRS during the COVID‐19 pandemic. Conclusion Intranasal corticosteroids remain the standard treatment for CRS in patients with SARS‐CoV‐2 infection. Surgical treatments should be reduced to a minimum and surgery preserved for patients with local complications and for those with no other treatment options. Systemic corticosteroids should be avoided. Treatment with biologics can be continued with careful monitoring in non‐infected patients and should be temporarily interrupted during the course of the COVID‐19 infection.

Published
2021

4. A compendium answering 150 questions on COVID‐19 and SARS‐CoV‐2

Author

Consejo Superior de Investigaciones Científicas (España), Ministerio de Economía y Competitividad (España), Instituto de Salud Carlos III, Riggioni, Carmen [0000-0002-8745-0228], Comberiat, Pasquale [0000-0001-5209-9733], Giovannini, Mattia [0000-0001-9568-6882], Agache, Ioana [0000-0001-7994-364X], Akdis, Mubeccel [0000-0003-0554-9943], Alves-Correia, Magna [0000-0002-7676-5558], Antó, Josep M. [0000-0002-4736-8529], Azkur, Ahmet Kursat [0000-0002-5597-8917], Azkur, Dilek [0000-0002-4396-9087], Boccabella, Cristina [0000-0003-1942-8886], Breiteneder, Heimo [0000-0003-2022-8689], Carvalho, Daniela [0000-0002-0432-3339], Vecillas, Leticia de las [0000-0003-4969-5678], Diamant, Zuzana [0000-0003-0133-0100], Eguiluz-Gracia, Ibon [0000-0002-3774-931X], Eiwegger, Thomas [0000-0002-2914-7829], Fokkens, Wytske [0000-0003-4852-229X], Gao, Ya-dong [0000-0003-1251-7608], Nadeau, Kari C. [0000-0002-2146-2955], O'Mahony, Liam [0000-0003-4705-3583], Pfaar, Oliver [0000-0003-4374-9639], Sanak, Marek [0000-0001-7635-8103], Schwarze, Jürgen [0000-0002-6899-748X], Sokolowska, Milena [0000-0001-9710-6685], Torres Jaén, María José [0000-0001-5228-471X], Veen, Willem van de [0000-0001-9951-6688], Zelm, Menno C. van [0000-0003-4161-1919], Wang, De Yun [0000-0002-0909-2963], Zhang, Luo [0000-0002-0910-9884], Jiménez Saiz, Rodrigo [0000-0002-0606-3251], Akdis, Cezmi A. [0000-0001-8020-019X], Riggioni, Carmen, Comberiat, Pasquale, Giovannini, Mattia, Agache, Ioana, Akdis, Mubeccel, Alves-Correia, Magna, Antó, Josep M., Arcolaci, Alessandra, Azkur, Ahmet Kursat, Azkur, Dilek, Beken, Burcin, Boccabella, Cristina, Bousquet, Jean, Breiteneder, Heimo, Carvalho, Daniela, Vecillas, Leticia de las, Diamant, Zuzana, Eguiluz-Gracia, Ibon, Eiwegger, Thomas, Eyerich, Stephanie, Fokkens, Wytske, Gao, Ya-dong, Hannachi, Farah, Johnston, Sebastian L., Jutel, Marek, Karavelia, Aspasia, Klimek, Ludfger, Moya, Beatriz, Nadeau, Kari C., O'Hehir, Robin, O'Mahony, Liam, Pfaar, Oliver, Sanak, Marek, Schwarze, Jürgen, Sokolowska, Milena, Torres Jaén, María José, Veen, Willem van de, Zelm, Menno C. van, Wang, De Yun, Zhang, Luo, Jiménez Saiz, Rodrigo, Akdis, Cezmi A., Consejo Superior de Investigaciones Científicas (España), Ministerio de Economía y Competitividad (España), Instituto de Salud Carlos III, Riggioni, Carmen [0000-0002-8745-0228], Comberiat, Pasquale [0000-0001-5209-9733], Giovannini, Mattia [0000-0001-9568-6882], Agache, Ioana [0000-0001-7994-364X], Akdis, Mubeccel [0000-0003-0554-9943], Alves-Correia, Magna [0000-0002-7676-5558], Antó, Josep M. [0000-0002-4736-8529], Azkur, Ahmet Kursat [0000-0002-5597-8917], Azkur, Dilek [0000-0002-4396-9087], Boccabella, Cristina [0000-0003-1942-8886], Breiteneder, Heimo [0000-0003-2022-8689], Carvalho, Daniela [0000-0002-0432-3339], Vecillas, Leticia de las [0000-0003-4969-5678], Diamant, Zuzana [0000-0003-0133-0100], Eguiluz-Gracia, Ibon [0000-0002-3774-931X], Eiwegger, Thomas [0000-0002-2914-7829], Fokkens, Wytske [0000-0003-4852-229X], Gao, Ya-dong [0000-0003-1251-7608], Nadeau, Kari C. [0000-0002-2146-2955], O'Mahony, Liam [0000-0003-4705-3583], Pfaar, Oliver [0000-0003-4374-9639], Sanak, Marek [0000-0001-7635-8103], Schwarze, Jürgen [0000-0002-6899-748X], Sokolowska, Milena [0000-0001-9710-6685], Torres Jaén, María José [0000-0001-5228-471X], Veen, Willem van de [0000-0001-9951-6688], Zelm, Menno C. van [0000-0003-4161-1919], Wang, De Yun [0000-0002-0909-2963], Zhang, Luo [0000-0002-0910-9884], Jiménez Saiz, Rodrigo [0000-0002-0606-3251], Akdis, Cezmi A. [0000-0001-8020-019X], Riggioni, Carmen, Comberiat, Pasquale, Giovannini, Mattia, Agache, Ioana, Akdis, Mubeccel, Alves-Correia, Magna, Antó, Josep M., Arcolaci, Alessandra, Azkur, Ahmet Kursat, Azkur, Dilek, Beken, Burcin, Boccabella, Cristina, Bousquet, Jean, Breiteneder, Heimo, Carvalho, Daniela, Vecillas, Leticia de las, Diamant, Zuzana, Eguiluz-Gracia, Ibon, Eiwegger, Thomas, Eyerich, Stephanie, Fokkens, Wytske, Gao, Ya-dong, Hannachi, Farah, Johnston, Sebastian L., Jutel, Marek, Karavelia, Aspasia, Klimek, Ludfger, Moya, Beatriz, Nadeau, Kari C., O'Hehir, Robin, O'Mahony, Liam, Pfaar, Oliver, Sanak, Marek, Schwarze, Jürgen, Sokolowska, Milena, Torres Jaén, María José, Veen, Willem van de, Zelm, Menno C. van, Wang, De Yun, Zhang, Luo, Jiménez Saiz, Rodrigo, and Akdis, Cezmi A.

Abstract

In December 2019, China reported the first cases of the coronavirus disease 2019 (COVID‐19). This disease, caused by the severe acute respiratory syndrome–related coronavirus 2 (SARS‐CoV‐2), has developed into a pandemic. To date, it has resulted in ~9 million confirmed cases and caused almost 500 000 related deaths worldwide. Unequivocally, the COVID‐19 pandemic is the gravest health and socioeconomic crisis of our time. In this context, numerous questions have emerged in demand of basic scientific information and evidence‐based medical advice on SARS‐CoV‐2 and COVID‐19. Although the majority of the patients show a very mild, self‐limiting viral respiratory disease, many clinical manifestations in severe patients are unique to COVID‐19, such as severe lymphopenia and eosinopenia, extensive pneumonia, a “cytokine storm” leading to acute respiratory distress syndrome, endothelitis, thromboembolic complications, and multiorgan failure. The epidemiologic features of COVID‐19 are distinctive and have changed throughout the pandemic. Vaccine and drug development studies and clinical trials are rapidly growing at an unprecedented speed. However, basic and clinical research on COVID‐19–related topics should be based on more coordinated high‐quality studies. This paper answers pressing questions, formulated by young clinicians and scientists, on SARS‐CoV‐2, COVID‐19, and allergy, focusing on the following topics: virology, immunology, diagnosis, management of patients with allergic disease and asthma, treatment, clinical trials, drug discovery, vaccine development, and epidemiology. A total of 150 questions were answered by experts in the field providing a comprehensive and practical overview of COVID‐19 and allergic disease.

Published
2020

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