The impact of the COVID-19 pandemic on antimicrobial usage: an international patient-level cohort study.

IF 3.3 Q2 INFECTIOUS DISEASES

JAC-Antimicrobial Resistance Pub Date : 2025-03-26 eCollection Date: 2025-04-01 DOI:10.1093/jacamr/dlaf037

Refath Farzana, Stephan Jürgen Harbarth, Ly-Mee Yu, Edoardo Carretto, Catrin E Moore, Nicholas Alexander Feasey, Ana C Gales, Ushma Galal, Onder Ergonul, Dongeun Yong, Md Abdullah Yusuf, Balaji Veeraraghavan, Kenneth Chukwuemeka Iregbu, James Anton van Santen, Aghata Cardoso da Silva Ribeiro, Carolina Maria Fankhauser, Chisomo Judith Chilupsya, Christiane Dolecek, Diogo Boldim Ferreira, Fatihan Pinarlik, Jaehyeok Jang, Lal Sude Gücer, Laura Cavazzuti, Marufa Sultana, M D Nazmul Haque, Murielle Galas Haddad, Nubwa Medugu, Philip Ifeanyi Nwajiobi-Princewill, Roberta Marrollo, Rui Zhao, Vivekanandan B Baskaran, J V Peter, Sujith J Chandy, Yamuna Devi Bakthavatchalam, Timothy R Walsh

{"title":"The impact of the COVID-19 pandemic on antimicrobial usage: an international patient-level cohort study.","authors":"Refath Farzana, Stephan Jürgen Harbarth, Ly-Mee Yu, Edoardo Carretto, Catrin E Moore, Nicholas Alexander Feasey, Ana C Gales, Ushma Galal, Onder Ergonul, Dongeun Yong, Md Abdullah Yusuf, Balaji Veeraraghavan, Kenneth Chukwuemeka Iregbu, James Anton van Santen, Aghata Cardoso da Silva Ribeiro, Carolina Maria Fankhauser, Chisomo Judith Chilupsya, Christiane Dolecek, Diogo Boldim Ferreira, Fatihan Pinarlik, Jaehyeok Jang, Lal Sude Gücer, Laura Cavazzuti, Marufa Sultana, M D Nazmul Haque, Murielle Galas Haddad, Nubwa Medugu, Philip Ifeanyi Nwajiobi-Princewill, Roberta Marrollo, Rui Zhao, Vivekanandan B Baskaran, J V Peter, Sujith J Chandy, Yamuna Devi Bakthavatchalam, Timothy R Walsh","doi":"10.1093/jacamr/dlaf037","DOIUrl":null,"url":null,"abstract":"Background: This study aimed to evaluate the trends in antimicrobial prescription during the first 1.5 years of COVID-19 pandemic.Methods: This was an observational, retrospective cohort study using patient-level data from Bangladesh, Brazil, India, Italy, Malawi, Nigeria, South Korea, Switzerland and Turkey from patients with pneumonia and/or acute respiratory distress syndrome and/or sepsis, regardless of COVID-19 positivity, who were admitted to critical care units or COVID-19 specialized wards. The changes of antimicrobial prescription between pre-pandemic and pandemic were estimated using logistic or linear regression. Pandemic effects on month-wise antimicrobial usage were evaluated using interrupted time series analyses (ITSAs).Results: Antimicrobials for which prescriptions significantly increased during the pandemic were as follows: meropenem in Bangladesh (95% CI: 1.94-4.07) with increased prescribed daily dose (PDD) (95% CI: 1.17-1.58) and Turkey (95% CI: 1.09-1.58), moxifloxacin in Bangladesh (95% CI: 4.11-11.87) with increased days of therapy (DOT) (95% CI: 1.14-2.56), piperacillin/tazobactam in Italy (95% CI: 1.07-1.48) with increased DOT (95% CI: 1.01-1.25) and PDD (95% CI: 1.05-1.21) and azithromycin in Bangladesh (95% CI: 3.36-21.77) and Brazil (95% CI: 2.33-8.42). ITSA showed a significant drop in azithromycin usage in India (95% CI: -8.38 to -3.49 g/100 patients) and South Korea (95% CI: -2.83 to -1.89 g/100 patients) after WHO guidelines v1 release and increased meropenem usage (95% CI: 93.40-126.48 g/100 patients) and moxifloxacin (95% CI: 5.40-13.98 g/100 patients) in Bangladesh and sulfamethoxazole/trimethoprim in India (95% CI: 0.92-9.32 g/100 patients) following the Delta variant emergence.Conclusions: This study reinforces the importance of developing antimicrobial stewardship in the clinical settings during inter-pandemic periods.","PeriodicalId":14594,"journal":{"name":"JAC-Antimicrobial Resistance","volume":"7 2","pages":"dlaf037"},"PeriodicalIF":3.3000,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11945301/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"JAC-Antimicrobial Resistance","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1093/jacamr/dlaf037","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/4/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}

引用次数: 0

Abstract

Background: This study aimed to evaluate the trends in antimicrobial prescription during the first 1.5 years of COVID-19 pandemic.

Methods: This was an observational, retrospective cohort study using patient-level data from Bangladesh, Brazil, India, Italy, Malawi, Nigeria, South Korea, Switzerland and Turkey from patients with pneumonia and/or acute respiratory distress syndrome and/or sepsis, regardless of COVID-19 positivity, who were admitted to critical care units or COVID-19 specialized wards. The changes of antimicrobial prescription between pre-pandemic and pandemic were estimated using logistic or linear regression. Pandemic effects on month-wise antimicrobial usage were evaluated using interrupted time series analyses (ITSAs).

Results: Antimicrobials for which prescriptions significantly increased during the pandemic were as follows: meropenem in Bangladesh (95% CI: 1.94-4.07) with increased prescribed daily dose (PDD) (95% CI: 1.17-1.58) and Turkey (95% CI: 1.09-1.58), moxifloxacin in Bangladesh (95% CI: 4.11-11.87) with increased days of therapy (DOT) (95% CI: 1.14-2.56), piperacillin/tazobactam in Italy (95% CI: 1.07-1.48) with increased DOT (95% CI: 1.01-1.25) and PDD (95% CI: 1.05-1.21) and azithromycin in Bangladesh (95% CI: 3.36-21.77) and Brazil (95% CI: 2.33-8.42). ITSA showed a significant drop in azithromycin usage in India (95% CI: -8.38 to -3.49 g/100 patients) and South Korea (95% CI: -2.83 to -1.89 g/100 patients) after WHO guidelines v1 release and increased meropenem usage (95% CI: 93.40-126.48 g/100 patients) and moxifloxacin (95% CI: 5.40-13.98 g/100 patients) in Bangladesh and sulfamethoxazole/trimethoprim in India (95% CI: 0.92-9.32 g/100 patients) following the Delta variant emergence.

Conclusions: This study reinforces the importance of developing antimicrobial stewardship in the clinical settings during inter-pandemic periods.

查看原文本刊更多论文

COVID-19大流行对抗微生物药物使用的影响：一项国际患者水平的队列研究

背景：本研究旨在评估COVID-19大流行前1.5年的抗菌药物处方趋势。方法：这是一项观察性、回顾性队列研究，使用来自孟加拉国、巴西、印度、意大利、马拉维、尼日利亚、韩国、瑞士和土耳其的肺炎和/或急性呼吸窘迫综合征和/或败血症患者的患者水平数据，无论COVID-19阳性，均入住重症监护病房或COVID-19专科病房。使用logistic或线性回归估计大流行前和大流行期间抗菌药物处方的变化。采用中断时间序列分析（ITSAs）评估大流行对按月抗菌药物使用的影响。结果：在大流行期间处方量显著增加的抗微生物药物如下：孟加拉国的美罗培南（95% CI: 1.94-4.07）增加了处方日剂量（PDD）（95% CI: 1.17-1.58）和土耳其的美罗培南（95% CI: 1.09-1.58），孟加拉国的莫西沙星（95% CI: 4.11-11.87）增加了治疗天数（DOT）（95% CI: 1.14-2.56），意大利的哌拉西林/他唑巴坦（95% CI: 1.07-1.48）增加了DOT （95% CI: 1.01-1.25）和PDD （95% CI: 1.09-1.58）。1.05-1.21)和阿奇霉素在孟加拉国（95% CI: 3.36-21.77）和巴西（95% CI: 2.33-8.42）。ITSA显示，在世卫组织指南v1版本发布后，印度（95% CI: -8.38至-3.49 g/100例患者）和韩国（95% CI: -2.83至-1.89 g/100例患者）阿奇霉素的使用量显著下降，在孟加拉国（95% CI: 93.40至126.48 g/100例患者）和莫西沙星（95% CI: 5.40至13.98 g/100例患者）的使用量增加，在Delta变异出现后，印度（95% CI: 0.92至9.32 g/100例患者）的磺胺甲恶唑/甲氧苄啶的使用量增加。结论：本研究强调了在大流行期间临床环境中发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