Association between ivy leaves dry extract EA 575 prescriptions and antibiotic use, sick leave duration, and repeated infections in adult patients.

OBJECTIVES: The present study aimed to analyze the association between the prescription of ivy leaf dry extract EA 575 (licensed under the trade name Prospan® in Germany) and the incidence of antibiotic use, incident bacterial complications, and days of sick leave in adult patients with cold diseases. METHODS: This retrospective cohort study was based on the IQVIA Disease Analyzer database and included adult patients from 1032 general practices in Germany with a documentation of common cold between 2017 and 2020 (index date) and prescription of either EA 575 or an antibiotic drug within 3 days after index date. 1:1 propensity score matching based on age, sex, index month, physician, health insurance status, and the Charlson Comorbidity Index was carried out. Univariable regression models were used to investigate the association between EA 575 prescription and defined outcomes. RESULTS: Data of 7034 patients treated with EA 575 and 7034 matched patients receiving an antibiotic were available. EA 575 prescription was associated with significantly lower odds of an antibiotic prescription in the time periods of 4-30 days (OR: 0.83; 95% CI: 0.72-0.96) and 31-365 days (OR: 0.44; 95% CI: 0.40-0.48) after the index date. EA 575 prescription was significantly associated with a lower rate of sick leave of more than 7 days (33.0% vs. 37.7%, OR: 0.81; 95% CI: 0.73-0.90) in patients with any sick leave, as well as with lower odds of a new cough diagnosis (OR: 0.91, 95% CI: 0.85-0.98) when compared to antibiotic prescription. CONCLUSION: Our study provides further evidence that the use of phytopharmaceuticals, in particular ivy leaf dry extract EA 575, could contribute to a reduction in the number of inappropriate antibiotic prescriptions for respiratory infection with cough symptoms.

Distribution and evolution of genetic caste determination in Pogonomyrmex seed-harvester ants.

We examined the distribution and ancestral relationships of genetic caste determination (GCD) in 46 populations of the seed-harvester ants Pogonomyrmex barbatus and P. rugosus across the east-to-west range of their distributions. Using a mtDNA sequence and two nuclear markers diagnostic for GCD, we distinguished three classes of population phenotypes: those with GCD, no evidence of GCD, and mixed (both GCD and non-GCD colonies present). The GCD phenotype was geographically widespread across the range of both morphospecies, occurring in 20 of 46 sampled populations. Molecular data suggest three reproductively isolated and cryptic lineages within each morphospecies, and no present hybridization. Mapping the GCD phenotype onto a mtDNA phylogeny indicates that GCD in P. rugosus was acquired from P. barbatus, suggesting that interspecific hybridization may not be the causal agent of GCD, but may simply provide an avenue for GCD to spread from one species (or subspecies) to another. We hypothesize that the origin of GCD involved a genetic mutation with a major effect on caste determination. This mutation generates genetic conflict and results in the partitioning and maintenance of distinct allele (or gene set) combinations that confer differences in developmental caste fate. The outcome is two dependent lineages within each population; inter-lineage matings produce workers, while intra-lineage matings produce reproductives. Both lineages are needed to produce a caste-functional colony, resulting in two reproductively isolated yet interdependent lineages. Pogonomyrmex populations composed of dependent lineages provide a unique opportunity to investigate genetic variation underlying phenotypic plasticity and its impact on the evolution of social structure.