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Objective: One of the fist lines of action of the National Plan against Antibiotic Resistance (PRAN) is to monitor the use of antibiotics as a fundamental basis for the fight against resistance. In order to know the antibiotic prescription habits, we pretended to describe the outpatient prescription of systemic antibiotics in the Balearic Islands through exploitation of ABPresclín database., Methods: It was an ecological descriptive study of the electronic outpatient prescriptions of systemic antibiotics of the Health Service of the Balearic Islands from 2012 to 2018. Combining the prescription with population information data by year and geographical area, prescription rates were obtained per 1,000 person, distributed by professional, health centres, geographical areas: distribution per patient characteristics, type of antibiotics and associated diagnoses., Results: 3,517,101 prescriptions are analyzed with an average prescription period (TPp) per 1,000 person-years of 472.1. A quarter of the population received at least one prescription of antibiotics. TPp was higher in over 80 years (899.0) and in women (553.4). 68.9% of the prescription was made in primary care (AP) and 17.9% in out-of-hours settings. TPp in AP was 333.1, varying from 192.3 to 527.0, according to basic health areas. The TPp of the most commonly used antibiotics was: amoxicillin/clavulanic (143), amoxicillin (95.9), azithromycin (54.5), fosfomycin (41.5) and ciprofloxacin (29.7). The main associated diagnoses were: lower respiratory infections (16.5%), urinary infections (15%), non-infectious (15%), tonsillitis (14.3%) and upper respiratory infections (13%)., Conclusions: Balearic Islands have a relatively low antibiotic prescription rate with a marked variability between prescribers. Amoxicillin/clavulanic was the most prescribed antibiotic, with an increase in azithromycin. Respiratory infections were the main reason for prescription. ABPresclín is useful to promote better use of antibiotics., Competing Interests: Disclosure The authors report no conflicts of interest in this work.

Objective: Epidemiological data on influenza is essential for resource management when the incidence of the disease in the population is very high, but not easily available in real-time. The objective of this study was to evaluate the use of a syndromic surveillance system for influenza-like illness in Primary Care (ILIsPC) and assess its level of agreement with the epidemiological data from the Influenza Sentinel Network., Localization: Health centres and deputising medical services in the Balearic Islands., Participants: Data from 122 epidemiological weeks for each system were included., Main Measures: Data from January 1, 2007 to January 31, 2010 were compared. ILIsPC rates were obtained from the diagnoses registered in electronic health records of Primary Care clinics and deputising medical services. Data from Sentinel Network were obtained from weekly epidemiological reports. Intraclass correlation coefficient was calculated and Bland - Altman plot constructed., Results: There was good agreement between both measures, with an intraclass correlation coefficient of 0.88 (95% CI: 0.83-0.91). After constructing a Bland-Altman plot, the precision between both rates was greater during the periods of the highest influenza incidence., Conclusions: We believe that the syndromic surveillance system ILIsPC, provides access to very useful data in real-time, especially during periods of high influenza incidence, such as during epidemics or the recent pandemic., (Copyright © 2010 Elsevier España, S.L. All rights reserved.)

Background: It is not common that community-acquired pneumonias studies include patients non treated in hospital. The objectives were: to determine the cases managed in the ambulatory setting; to describe the clinical features; to identify the aetiological agents, and to describe the treatment, comparing inpatients with outpatients., Patients and Methods: Observational prospective study. Population attended at three teaching primary care centers of Palma de Mallorca (60,450 habitants). Patients (> 14 years) were investigated when diagnosticated of community-acquired pneumoniae, from November 1992 to December 1994. Exclussions: HIV infection, patients living in a nursing home and tuberculosis. Data were collected in both Hospital and primary health care centers. Epidemiological, clinical, radiological and laboratory findings were recorded at the initial visit and 21 days after., Results: 91 cases were investigated. 57% were managed at the primary care centers exclusively, 63.3% of the patients who went initially to the hospital were admitted in; but only 10.9% of those who went initially to the primary care centers (p < 0.005). 24 patients were hospitalized. 56 microbiological agents were identified in 48 patients (52.7%): Mycoplasma pneumoniae (10); Streptococcus pneumoniae (9); Influenza B (8); Chlamydia psittacci (7); Influenza A (7); Coxiella burnetii (5); Chlamydia pneumoniae (4); Legionella (3); Adenovirus (2); and Parainfluenza 3 (1). Mycoplasma was predominant in outpatients: 9 cases. S. pneumoniae in inpatients: 5 cases. Eritromycin was the most common treatment prescribed (76.9% of patients), alone or in combination with other antibiotics. Monotherapy was most common at primary care yield (96.7%) than at the hospital (45.2%) (p < 0.005)., Conclusions: Most of the patients with community-acquired pneumonias are managed at primary health care centers. M. pneumoniae is the predominant microbiological agent in outpatients and S. pneumoniae in inpatients. Erithromycin is the most used antibiotic in both groups of patients.