@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{MuellerKleinertHillermannetal.2021,
  author    = {M{\"u}ller, Frank and Kleinert, Evelyn and Hillermann, Nele and Simmenroth, Anne and Hummers, Eva and Zychlinsky Scharff, Anna and Dopfer, Christian and Happle, Christine and Jablonka, Alexandra},
  title     = {Disease burden in a large cohort of asylum seekers and refugees in Germany},
  series = {Journal of Global Health},
  volume    = {11},
  journal   = {Journal of Global Health},
  doi       = {10.7189/jogh.11.04002},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-371228},
  year      = {2021},
  abstract  = {Background: Currently, health care systems worldwide are challenged with providing care to an increasing number of migrants, refugees, and displaced persons. In this article, we report on disease burden and drug prescription patterns in a large refugee cohort in Germany. Methods: We conducted a cross-sectional study of anonymized medical records including demographic data, diagnoses, and drug prescriptions in two refugee reception centres between 2015 and 2019. Refugees and migrants received medical assistance exclusively through the on-site clinics. Thus, this study represents all medical visits of the housed residents. Results: In total, n = 15531 diagnoses from n = 4858 patients in a cohort of n = 10431 accommodated refugees were recorded. N = 11898 medications were prescribed. Overall, 29.8\% of all refugees sought medical attention. Half of the patients were female (49.6\%), the average age was 23.8 years (SD [standard deviation] 17.0, min 0, max 81), and 41.5\% were minors (<18 years). Most patients had Middle Eastern or Northern African origin (63.9\%). The largest proportion of diagnoses belonged to the ICD (International Statistical Classification of Diseases and Related Health Problems) category "R" (miscellaneous, 33.5\%), followed by diseases of the respiratory system (category "J", 16.5\%), or the musculoskeletal system (category "M", 7.1\%). Non-steroidal anti-inflammatory drugs were most frequently prescribed. Conclusions: This analysis in two large refugee centres in Germany shows that about one third of refugees seek medical attention upon initial arrival. Complaints are manifold, with a high prevalence of respiratory infections.},
  language  = {en}
}