Background: Pediatric hematology-oncology (PHO) and bone marrow transplantation (BMT) units have high use of antimicrobials. Objectives: To survey antimicrobials used in Greek PHO and BMT units before and after an intervention involving education on the 2017 clinical practice guidelines (CPG) for the management of febrile neutropenia in children with cancer and hematopoietic stem cell transplant recipients. Methods: Antibiotic prescribing practices were prospectively recorded between June 2016 and November 2017. In December 2017, education for the CPG took place and antibiotic prescribing practices were followed for one more year. For antibiotic stewardship, days of therapy and length of therapy were calculated. Results: Five of six PHO units and the single pediatric BMT unit covering >92% of children with hematologic and oncologic diseases in Greece participated. Administration of ≥ 4 antibiotics simultaneously and of antibiotics with overlapping activity for ≥ 2 days was significantly more common in PHO units located in general compared to pediatric hospitals. Use of at least one antifungal was recorded in approximately 47% of the patients before and after the intervention. De-escalation and/or discontinuation of antibiotics on day 6 of initial treatment increased significantly from 43% to 53.5% (p=0.032). Although the number of patients requiring support in the intensive care unit for sepsis did not change, a significant drop was noted in all-cause mortality after the intervention (p=0.008). Conclusion: Our surveillance was able to accurately document the antibiotic prescribing practices of Greek PHO and BMT units. Moreover, it identified areas in immediate need for improvement in antibiotic stewardship.

Rational, aims and objectives: Our study aims to assess attitudes, knowledge and influenza vaccine uptake of school teachers and the intention to uptake influenza vaccine as well as the COVID-19 vaccine and to identify factors associated with vaccine acceptance during the COVID-19 pandemic in Greece. Methods: A cross-sectional online survey was conducted among school teachers in the area of Western Greece from June 2020 to August 2020. A self-administered questionnaire was distributed via an internet-based link along with an invitation email. Results: Responses from 399 participants were retrieved. 139 (34.8%) had received the annual influenza vaccine in the season 2019-2020 whereas 215 (53.9%) stated that they would get it in the forthcoming season 2020-202(p < 0.001). 152 (38.1%) intent to get the COVID-19 vaccine when available. For COVID-19 vaccine factors that were independently associated with the intention to uptake included more than 15 years at work (p=0.001), prior influenza vaccine uptake (p=0.003), believing that COVID 19 vaccine should be mandatory (p=0.04) and that school teachers are a high-risk group for COVID-19 (p=0.001). Conclusion: The COVID-19 pandemic appeared to have an impact on the intention of school teachers to get vaccinated for influenza. The low level of COVID-19 vaccine acceptance intention amongst the teachers in our cohort warrants further attention. Public health interventions should aim to increase knowledge on both influenza and COVID-19 and prevention of them via immunization in this particular at-risk population.

Background: A series of repeated questionnaire surveys among 8- and 9-year-old schoolchildren in the city of Patras, Greece, demonstrated a continuous rise in the prevalence of wheeze/asthma from 1978 to 2003, with a plateau between 2003 and 2008. We further investigated wheeze/asthma trends within the same environment during the last decade. Methods: Two further identical cross-sectional surveys were conducted in 2013 (N=2554) and 2018 (N=2648). Physician-diagnosed wheeze and asthma were analysed separately and in relation to their occurrence (recent-onset: solely within the last two years; non-current: prior to the last two years; persistent: both before and within the last two years). In addition, in 2018, spirometry was performed in participants reporting relevant symptoms and in a random sample of healthy controls. Results: The prevalence of current wheeze/asthma declined from 6.9% in 2008 to 5.2% in 2013 and 4.3% in 2018. The persistent and non-current wheeze/asthma groups (both including children with symptoms at preschool age) followed this overall trend, while the prevalence of recent-onset wheeze/asthma remained unchanged. Persistent and non-current wheezers were also more frequently diagnosed with asthma, in contrast to those with recent-onset wheeze. Children with recent-onset wheeze/asthma and a considerable fraction of those with persistent symptoms had lower lung function. Conclusions: The prevalence of childhood wheeze/asthma has declined significantly during the last decade in Greece. Our analysis suggests that the reversing trend is most likely attributed to changing asthma perceptions among physicians and/or parents, especially in the case of preschool children with troublesome respiratory symptoms.