Antibiotic use for respiratory infections among Hajj pilgrims: A cohort survey and review of the literature

To evaluate the occurrence and determinants associated with antibiotic use for respiratory tract infections (RTIs) among Hajj pilgrims. Prospective cohort surveys were conducted among French pilgrims from 2012 to 2017. We also conducted a systematic review about available evidence for antibiotic con...

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Bibliographic Details
Published in:Travel medicine and infectious disease 2019-07, Vol.30, p.39-45
Main Authors: Hoang, Van-Thuan, Nguyen, Thi-Thu-Thuy, Belhouchat, Khadidja, Meftah, Mohammed, Sow, Doudou, Benkouiten, Samir, Dao, Thi-Loi, Anh Ly, Tran Duc, Drali, Tassadit, Yezli, Saber, Alotaibi, Badriah, Raoult, Didier, Parola, Philippe, Pommier de Santi, Vincent, Gautret, Philippe
Format: Article
Language:English
Subjects:
Antibiotic
Antibiotics
Chronic illnesses
Cohorts
Determinants
Dyspnea
Fever
Hajj
Health risk assessment
Human health and pathology
Hypertension
Immunization
Infections
Infectious diseases
Life Sciences
Pilgrims
Polls & surveys
Questionnaires
Recommendation
Respiratory tract
Respiratory tract infections
Statistical analysis
Surveying
Surveys
Symptoms
Systematic review
Travel medicine
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Summary:To evaluate the occurrence and determinants associated with antibiotic use for respiratory tract infections (RTIs) among Hajj pilgrims. Prospective cohort surveys were conducted among French pilgrims from 2012 to 2017. We also conducted a systematic review about available evidence for antibiotic consumption in relation with RTIs during the Hajj. 783 pilgrims were included in the survey. During the Hajj, 85.3% presented respiratory symptoms and 47.6% used antibiotics. Pilgrims with productive cough or fever were three times and twice as likely to have used antibiotics. Dry cough, sore throat and voice failure were also associated with increased antibiotic use. 26.3% of pilgrims presented symptoms compatible with a lower tract respiratory infection. According to the French recommendations, only 39.6% of pilgrims who used an antibiotic actually had an indication for it. Antibiotic intake was associated with an increased frequency of persistent symptoms post-Hajj (aRR = 1.31, 95%CI [1.04–1.66]). The review included 14 articles. The use of antibiotic for respiratory tract infections during the Hajj varied from 7% to 58.5%. In 9 studies, the antibiotic consumption rate was >30%. Respiratory tract infections are common during the Hajj, leading to high prevalence of inappropriate antibiotic intake.
ISSN:1477-8939
1873-0442
DOI:10.1016/j.tmaid.2019.06.007