The pandemic of COVID-19 has brought many changes in health care systems at all levels of health care. The increase in the number of cases of COVID-19 has led to overuse and misuse of antibiotics.The aim of this study was to compare the consumption of antibiotics for systemic use in outpatients in the Republic of Srpska (RS), before and during the first year of the COVID-19 pandemic, as well as the association between antibiotic consumption and the rate of incidence and mortality of COVID-19. The total consumption of the antibiotics for systemic use (J01) in outpatients in the Republic of Srpska during 2019 was 19.40 DDD/TID, with an increase to 30.80 DDD/TID in 2020.Significantly higher use of penicillin (10.58 ± 11.01 DDD/TID in 2019 vs. 17.10 ± 13.63 DDD/TID in 2020), cephalosporins (2.68 ± 1.90 DDD/TID in 2019 vs. 5.93 ± 2.77 DDD/TID in 2020) and macrolides (2.14 ± 2.22 DDD/TID in 2019 vs. 3.40 ± 3.44 DDD/TID in 2020) was observed during the pandemic period. It is necessary to improve the prescribing practice of antibiotics at the primary health care level, public awareness about rational use of antibiotics, as well as the current antibiotic stewardship programs and control their implementation.

The constant worsening of antimicrobial resistance (AMR) imposes the need for an urgent response. Use of antibiotics (AB), both due to irrational prescribing by doctors and irrational use by patients, is recognized as one of the leading causes of this problem. This study aimed to identify knowledge, attitudes, and practices about AB use and AMR within the general population, stratified by age, gender, and urban/rural areas during the COVID-19 pandemic. This questionnaire-based cross-sectional study was conducted in April 2022 among patients who visited three health centers in the eastern region of Bosnia and Herzegovina. A high frequency of AB use was observed during the COVID-19 pandemic (64.2% of respondents were treated with AB). Age and place of residence have not been shown to be factors associated with AB use practices that pose a risk for AMR. However, female gender (β = 0.063; p = 0.041), better knowledge (β = 0.226; p < 0.001), and positive attitudes (β = 0.170; p < 0.001) about use of AB and towards to AMR proved to be factors associated with better practice by respondents. Women, younger respondents, and respondents from urban areas showed better knowledge, attitudes, and behavior about the use of AB and AMR during the COVID-19 pandemic.

Introduction: Ventral incisional hernia repair remains a significant surgical challenge, with ongoing debate regarding the optimal approach. While laparoscopic intraperitoneal onlay mesh (IPOM+) and open Rives–Stoppa techniques are widely utilized, a comprehensive understanding integrating perioperative clinical outcomes, patient-reported quality of life, and the systemic stress response is lacking. This study aimed to compare these two surgical techniques across these multifaceted domains. Methods: This prospective non-randomized comparative study enrolled 96 adult patients (n = 48 per group) undergoing elective ventral incisional hernia repair via either laparoscopic IPOM+ or open Rives–Stoppa techniques. Perioperative clinical outcomes (operative time, hospital stay, bowel function, pain, analgesic use, complications, self-reported return to daily activities) and EuraHS-QoL scores were assessed. A comprehensive panel of endocrine (cortisol, ACTH, prolactin), inflammatory (IL-6, CRP, presepsin, procalcitonin), and coagulation (D-dimer) biomarkers were measured preoperatively and on the first postoperative day. Results: Laparoscopic IPOM+ repair was associated with more favorable postoperative recovery compared to open repair, characterized by reduced pain, shorter hospital stay, faster return to daily activities and better patient-reported quality of life (all p < 0.001). No significant time-by-group interactions were observed for endocrine or coagulation markers, indicating comparable perioperative trajectories (p > 0.05), while the inflammatory response (IL-6, C-reactive protein, presepsin, and procalcitonin) differed between the two approaches. Significant time-by-group interactions were found for IL-6 (p = 0.005), C-reactive protein (p = 0.015), presepsin (p = 0.040) and procalcitonin (p = 0.006). These associations remained after adjustment for baseline age, BMI, employment status and ASA classification. However, following Bonferroni’s adjustment for multiple comparisons, the observed associations between the biomarkers and the outcome did not remain statistically significant. Conclusions: Laparoscopic IPOM+ was associated with more favorable postoperative recovery and lower one-month EuraHS-QoL scores compared to the open Rives–Stoppa repair. Although some biomarkers suggested a possible difference in the postoperative inflammatory response between the two groups, further studies are needed to determine whether these findings reflect true biological differences between the surgical techniques.