东南亚 COVID-19 住院病人的抗生素处方和细菌感染:系统回顾和荟萃分析。

IF 3.7 Q2 INFECTIOUS DISEASES
JAC-Antimicrobial Resistance Pub Date : 2024-06-11 eCollection Date: 2024-06-01 DOI:10.1093/jacamr/dlae093
Achiraya Chanapal, Hung-Yung Cheng, Helen Lambert, Wenjuan Cong
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引用次数: 0

摘要

背景:据观察,为治疗 COVID-19 患者而开具抗生素处方的情况经常发生,而且往往没有明确的理由。这种趋势令人担忧可能会加剧抗菌药耐药性(AMR)。尽管东南亚国家对 AMR 的担忧由来已久,但有关这一问题的数据却非常缺乏:探讨 COVID-19 对 COVID-19 住院患者抗生素处方、细菌感染率和常见耐药病原体的影响:我们检索了 PubMed、EMBASE、Web of Science 和 ThaiJO(泰国学术数据库),以确定在东盟成员国进行的、2019 年 12 月至 2023 年 3 月间发表的研究。筛选和数据提取工作由两名独立审稿人完成,结果采用随机效应荟萃分析和描述性统计分析进行综合。本综述已在 PROSPERO 注册(CRD42023454337):在纳入最终分析的 29 项研究(19 750 例确诊 COVID-19 病例)中,抗生素处方率为 62.0%(95%CI:46.0%-76.0%),轻度/中度病例的处方率为 58.0%(21.0%-91.0%),而重度/危重病例的处方率为 91.0%(82.0%-98.0%)。值得注意的是,80.5% 的处方抗生素属于世界卫生组织 AWaRe "观察 "名单,其次是 "可获得 "名单(18.4%)和 "储备 "名单(1.0%)。报告的细菌感染率为 16.0%(7.0%-29.0%),其中鲍曼不动杆菌是最常见的耐药细菌,占 7.7%。新加坡的抗生素处方率较低,为 17.0%,细菌感染率较低,为 10.0%:结论:抗生素处方率高,与细菌感染不成比例,而且各国对 COVID-19 住院病人的做法各不相同,这突出表明该地区迫切需要合作应对和减轻 AMR。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Antibiotic prescribing and bacterial infection in COVID-19 inpatients in Southeast Asia: a systematic review and meta-analysis.

Background: The prescribing of antibiotics to treat COVID-19 patients has been observed to occur frequently, often without clear justification. This trend raises concerns that it may have exacerbated antimicrobial resistance (AMR). Despite longstanding concerns over AMR in Southeast Asian countries, data on this issue are notably lacking.

Objectives: To explore the impact of COVID-19 on antibiotic prescribing, bacterial infection prevalence and common resistant pathogens in COVID-19 inpatients.

Methods: We searched PubMed, EMBASE, Web of Science and ThaiJO (a Thai academic database) to identify studies conducted in ASEAN member countries and published between December 2019 and March 2023. Screening and data extraction were done by two independent reviewers, with results synthesized using random-effects meta-analyses and descriptive statistical analyses. This review was registered with PROSPERO (CRD42023454337).

Results: Of the 29 studies (19 750 confirmed COVID-19 cases) included for final analysis, the antibiotic prescribing rate was 62.0% (95%CI: 46.0%-76.0%) with a prescribing rate of 58.0% (21.0%-91.0%) in mild/moderate cases versus 91.0% (82.0%-98.0%) in severe/critical cases. Notably, 80.5% of antibiotics prescribed fall under the WHO AWaRe 'Watch' list, followed by 'Access' at 18.4% and 'Reserve' at 1.0%. The reported bacterial infection prevalence was 16.0% (7.0%-29.0%), with Acinetobacter baumannii being the most common resistant bacterium at 7.7%. Singapore was notable for its lower antibiotic prescribing rate of 17.0% and a lower bacterial infection rate of 10.0%.

Conclusions: High antibiotic prescribing rates, disproportionate to bacterial infections and varying practices for COVID-19 inpatients across countries highlight the urgent need for this region to collaborate to tackle and mitigate AMR.

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CiteScore
5.30
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