Tsioutis, Constantinos

Introduction: Promoting vaccination for coronavirus disease 2019 (COVID-19), especially for high-risk groups such as the elderly and persons with comorbidities, is important for reducing the incidence of severe disease and death. Methods: Retrospective cross-sectional study of factors associated with COVID-19 vaccination, including previous influenza vaccination, among all persons who received medical services in a rural area in Crete, Greece, between October 2020-May 2021. Results: Among 3129 participants, receipt of influenza vaccination in 2020–21 was strongly associated with COVID-19 vaccination, as was influenza vaccination in 2019–20, albeit to a lesser extent. In addition, persons older than 59 years (with exception of those 90 + years old) and those who lived closer to the hospital/health center, were more likely to vaccinate for COVID-19. Persons younger than 40 years of age, females, persons with mental illness or neurologic disease, were also less likely to vaccinate for COVID-19 (all p < 0.001). Conclusions: COVID-19 vaccination was more likely among those who were vaccinated for influenza before and during the pandemic. Access to healthcare services and specific comorbidities, were important influencers for vaccination, underlying the importance of tailored interventions to enforce vaccination in high-risk groups.

Objectives: Understanding antimicrobial prescribing attitudes and perceptions, especially in the early stages of medical training, is an important driver for appropriate interventions. This study examined junior doctors’ knowledge, attitudes and perceptions regarding antimicrobial use and antimicrobial resistance in Greece. Methods: A self-administered, internet-based questionnaire survey was completed by trainees and residents of all primary care centres and hospitals in Crete, Greece. Results: From the 313 invited junior doctors, 214 (68.4%) fully completed the questionnaire. The mean correct knowledge score (four items) was 60%. The highest confidence rates with prescribing were recorded in accurately diagnosing an infection that needs antimicrobial treatment, selecting an appropriate administration route, and selecting the appropriate dosage. The lowest confidence rates were recorded in modifying antimicrobial treatment based on clinical and/or microbiological evidence, prescribing antimicrobial combinations and not prescribing an antimicrobial in a febrile patient without severity criteria and uncertain diagnosis of infection. Use of guidelines and expert consultation were perceived as the most important factors influencing antimicrobial prescribing practices. Most participants were aware of the antimicrobial resistance problem in Greece, and considered excessive prescribing of antimicrobials and broad-spectrum antimicrobials to be the most important causes. Availability of local and national guidelines and antimicrobial resistance data, senior consultation and infectious diseases specialist consultation were the preferred interventions to improve antimicrobial prescribing. Conclusions: The findings of this study will contribute to the design of appropriate interventions, based on local evidence, for the establishment of antimicrobial stewardship programs in a country characterised by excessive use of antimicrobials and high resistance rates.