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":"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","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":"<p><strong>Background: </strong>This study aimed to evaluate the trends in antimicrobial prescription during the first 1.5 years of COVID-19 pandemic.</p><p><strong>Methods: </strong>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).</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>This study reinforces the importance of developing antimicrobial stewardship in the clinical settings during inter-pandemic periods.</p>","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":"{\"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\":\"<p><strong>Background: </strong>This study aimed to evaluate the trends in antimicrobial prescription during the first 1.5 years of COVID-19 pandemic.</p><p><strong>Methods: </strong>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).</p><p><strong>Results: </strong>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). 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The impact of the COVID-19 pandemic on antimicrobial usage: an international patient-level cohort study.
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.
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