@article{KleinertHillermannJablonkaetal.2021, author = {Kleinert, Evelyn and Hillermann, Nele and Jablonka, Alexandra and Happle, Christine and M{\"u}ller, Frank and Simmenroth, Anne}, title = {Prescription of antibiotics in the medical care of newly arrived refugees and migrants}, series = {Pharmacoepidemiology and Drug Safety}, volume = {30}, journal = {Pharmacoepidemiology and Drug Safety}, number = {8}, doi = {10.1002/pds.5254}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-244771}, pages = {1074 -- 1083}, year = {2021}, abstract = {Purpose Unnecessary and inappropriate use of antibiotics is a widespread problem in primary care. However, current data on the care of refugees and migrants in initial reception centers is pending. This article provides data on prescription frequencies of various antibiotics and associated diagnoses. Methods In this retrospective observational study, patient data of 3255 patients with 6376 medical contacts in two initial reception centers in Germany were analyzed. Patient data, collected by chart review, included sociodemographic characteristics, diagnoses, and prescriptions. Antibiotic prescription behavior and corresponding physician-coded diagnoses were analyzed. Results Nineteen percent of all patients in our study received systemic antibiotics during the observation period, with children below the age of 10 years receiving antibiotics most frequently (24\%). The most commonly prescribed antibiotics were penicillins (65\%), macrolides (12\%), and cephalosporins (7\%). The most frequent diagnoses associated with antibiotic prescription were acute tonsillitis (26\%), bronchitis (21\%), infections of the upper respiratory tract (14\%), and urinary tract infections (10\%). In case of acute bronchitis 74\% of the antibiotic prescriptions were probably not indicated. In addition, we found a significant number of inappropriate prescriptions such as amoxicillin for tonsillitis (67\%), and ciprofloxacin and cotrimoxazol for urinary tract infections (49\%). Conclusion Regarding inappropriate prescription of antibiotics in refugee healthcare, this study shows a rate ranging from 8\% for upper respiratory tract infections to 75\% for acute bronchitis. Unnecessary use of antibiotics is a global problem contributing to gratuitous costs, side effects, and antimicrobial resistance. This research contributes to the development of stringent antibiotic stewardship regiments in the particularly vulnerable population of migrants and refugees.}, language = {en} } @article{ZimniakKirschnerHilpertetal.2021, author = {Zimniak, Melissa and Kirschner, Luisa and Hilpert, Helen and Geiger, Nina and Danov, Olga and Oberwinkler, Heike and Steinke, Maria and Sewald, Katherina and Seibel, J{\"u}rgen and Bodem, Jochen}, title = {The serotonin reuptake inhibitor Fluoxetine inhibits SARS-CoV-2 in human lung tissue}, series = {Scientific Reports}, volume = {11}, journal = {Scientific Reports}, doi = {10.1038/s41598-021-85049-0}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-259820}, pages = {5890}, year = {2021}, abstract = {To circumvent time-consuming clinical trials, testing whether existing drugs are effective inhibitors of SARS-CoV-2, has led to the discovery of Remdesivir. We decided to follow this path and screened approved medications "off-label" against SARS-CoV-2. Fluoxetine inhibited SARS-CoV-2 at a concentration of 0.8 mu g/ml significantly in these screenings, and the EC50 was determined with 387 ng/ml. Furthermore, Fluoxetine reduced viral infectivity in precision-cut human lung slices showing its activity in relevant human tissue targeted in severe infections. Fluoxetine treatment resulted in a decrease in viral protein expression. Fluoxetine is a racemate consisting of both stereoisomers, while the S-form is the dominant serotonin reuptake inhibitor. We found that both isomers show similar activity on the virus, indicating that the R-form might specifically be used for SARS-CoV-2 treatment. Fluoxetine inhibited neither Rabies virus, human respiratory syncytial virus replication nor the Human Herpesvirus 8 or Herpes simplex virus type 1 gene expression, indicating that it acts virus-specific. Moreover, since it is known that Fluoxetine inhibits cytokine release, we see the role of Fluoxetine in the treatment of SARS-CoV-2 infected patients of risk groups.}, language = {en} }