Policy impact of a COVID-19 Response Team: Global perspective and UK case study

at each facility over a two-week period (one set) and each set is repeated every 4-6 weeks for a total of four sets (eight surveys) over six months to capture any seasonal differences in infection burden or antibiotic prescribing.Each survey is conducted for half a day, representative of a standard clinic session.Data are collected electronically using Open Data Kit (ODK) Collect.For each survey, anonymous consultation data of all patients presenting with acute infection symptoms (present for < 14 days) are collected including demographics, underlying conditions, presenting infection symptoms and antibiotic prescribing.Results: As of April 2024, six surveys in North-West province and two surveys in Gauteng province have been completed with data for 615 patients were recorded.Overall, there were 304 males (49%) and 311 females (51%).The most common symptoms were genital discharge (n = 134; 21.8%), painful urination (n = 113; 18.4%), acute cough (n = 109; 17.7%), sore throat (n = 83; 13.5%) and skin swelling or pain (n = 67; 10.9%); patients could have had more than one symptom.At least one antibiotic was prescribed for 87.0% of patients (n = 533).More than half (53.4%; n = 455) of antibiotics prescribed were Access antibiotics, 46.6% (n = 397) were Watch antibiotics, and no Reserve antibiotics were prescribed.Ceftriaxone (n = 182; 29.7%), amoxicillin (n = 180; 29.4%), azithromycin (n = 174; 28.4%) and metronidazole (n = 170; 27.7%) were the most frequently prescribed antibiotics. Conclusion:The preliminary results show very high rates of antibiotic prescribing in primary healthcare and high use of Watch antibiotics in this setting.This is a concern which warrants the need for antimicrobial stewardship programmes and further assessment of appropriateness of prescribing in ambulatory care.The study demonstrates the value of collecting infection and prescribing data based around the WHO AWaRe Antibiotic Book guidelines and will enable South Africa to evaluate its antimicrobial use.