Impact of COVID-19 pandemic on the utilization and quality of antibiotic use in the primary care setting in England, March 2019-March 2023: a segmented interrupted time series analysis of over 53 million individuals.

IF 4.2 2区 医学 Q1 INFECTIOUS DISEASES
Amanj Kurdi, Najla Al Mutairi, Kirmanj Baker, Karwan M-Amen, Omeed Darweesh, Hardee Karwi, Andrew Seaton, Jacqueline Sneddon, Brian Godman
{"title":"Impact of COVID-19 pandemic on the utilization and quality of antibiotic use in the primary care setting in England, March 2019-March 2023: a segmented interrupted time series analysis of over 53 million individuals.","authors":"Amanj Kurdi, Najla Al Mutairi, Kirmanj Baker, Karwan M-Amen, Omeed Darweesh, Hardee Karwi, Andrew Seaton, Jacqueline Sneddon, Brian Godman","doi":"10.1080/14787210.2024.2368816","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Amid the COVID-19 pandemic, we evaluated the short-term impact of COVID-19 on antibiotic use in primary care in England, focusing on both antibiotic quantity (overuse) and quality (misuse) of use.</p><p><strong>Research design and methods: </strong>A population-based segmented interrupted analysis was applied on monthly dispensed antibiotics prescriptions using the Prescription Cost Analysis dataset (March/2019-March/2023). The quantity was assessed using number of items dispensed per 1000 inhabitants (NTI) and defined daily doses per 1000 inhabitants per day (DID), while quality was evaluated using WHO's Access Watch Reserve (AWaRe) classification, the proportion of '4C' antibiotics and the percentage of broad- to narrow-spectrum antibiotics.</p><p><strong>Results: </strong>Findings indicate 8.6 (17.2%) and 0.4 (2.6%) increase in the NTI and DID, respectively, with a statistically significant uptick in trend noted after the second lockdown (β<sub>5</sub>) for 'total antibiotics' for NTI only (β<sub>5</sub> = 1.6; 95% CI:0.17, 3.1). Quality assessment showed an increase in 'Access' antibiotics from 77% in March/2019 to 86% in March/2023; however, COVID-19 had no significant impact on WHO AWaRe classes.</p><p><strong>Conclusion: </strong>COVID-19's impact on antibiotic use quality and quantity appeared to be minimal, though an increase in utilization post-second lockdown coincided with healthcare system recovery. This suggests a nuanced impact of the pandemic, highlighting the importance of continued antimicrobial stewardship.</p>","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"1-12"},"PeriodicalIF":4.2000,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Expert Review of Anti-infective Therapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/14787210.2024.2368816","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Amid the COVID-19 pandemic, we evaluated the short-term impact of COVID-19 on antibiotic use in primary care in England, focusing on both antibiotic quantity (overuse) and quality (misuse) of use.

Research design and methods: A population-based segmented interrupted analysis was applied on monthly dispensed antibiotics prescriptions using the Prescription Cost Analysis dataset (March/2019-March/2023). The quantity was assessed using number of items dispensed per 1000 inhabitants (NTI) and defined daily doses per 1000 inhabitants per day (DID), while quality was evaluated using WHO's Access Watch Reserve (AWaRe) classification, the proportion of '4C' antibiotics and the percentage of broad- to narrow-spectrum antibiotics.

Results: Findings indicate 8.6 (17.2%) and 0.4 (2.6%) increase in the NTI and DID, respectively, with a statistically significant uptick in trend noted after the second lockdown (β5) for 'total antibiotics' for NTI only (β5 = 1.6; 95% CI:0.17, 3.1). Quality assessment showed an increase in 'Access' antibiotics from 77% in March/2019 to 86% in March/2023; however, COVID-19 had no significant impact on WHO AWaRe classes.

Conclusion: COVID-19's impact on antibiotic use quality and quantity appeared to be minimal, though an increase in utilization post-second lockdown coincided with healthcare system recovery. This suggests a nuanced impact of the pandemic, highlighting the importance of continued antimicrobial stewardship.

COVID-19 大流行对 2019 年 3 月至 2023 年 3 月英格兰初级医疗机构抗生素使用情况和质量的影响:对 5300 多万人进行的分段间断时间序列分析。
背景:在COVID-19大流行期间,我们评估了COVID-19对英格兰初级保健中抗生素使用的短期影响,重点关注抗生素使用的数量(过度使用)和质量(滥用):使用处方成本分析数据集(2019 年 3 月至 2023 年 3 月)对每月配发的抗生素处方进行基于人群的分段间断分析。数量评估采用的是每 1000 名居民的配药数量(NTI)和每 1000 名居民每天的定义日剂量(DID),质量评估采用的是世界卫生组织的使用观察储备(AWaRe)分类、"4C "抗生素的比例以及广谱抗生素与窄谱抗生素的比例:结果表明,NTI 和 DID 分别增加了 8.6 (17.2%) 和 0.4 (2.6%),仅 NTI 的 "抗生素总量 "在第二次封锁 (β5)后出现了统计学意义上的显著上升趋势 (β5 = 1.6; 95% CI:0.17, 3.1)。质量评估显示,"可获得 "抗生素的比例从2019年3月的77%增至2023年3月的86%;然而,COVID-19对世卫组织AWaRe类别没有显著影响:COVID-19对抗生素使用质量和数量的影响似乎微乎其微,尽管第二次封锁后使用量的增加与医疗系统的恢复相吻合。这表明大流行带来了细微的影响,突出了持续开展抗菌药物管理的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
11.20
自引率
0.00%
发文量
66
审稿时长
4-8 weeks
期刊介绍: Expert Review of Anti-Infective Therapy (ISSN 1478-7210) provides expert reviews on therapeutics and diagnostics in the treatment of infectious disease. Coverage includes antibiotics, drug resistance, drug therapy, infectious disease medicine, antibacterial, antimicrobial, antifungal and antiviral approaches, and diagnostic tests.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信