TY - JOUR
T1 - The impact of the COVID-19 pandemic on antimicrobial usage
T2 - an international patient-level cohort study
AU - Farzana, Refath
AU - Harbarth, Stephan Jürgen
AU - Yu, Ly-Mee
AU - Carretto, Edoardo
AU - Moore, Catrin E
AU - Feasey, Nicholas Alexander
AU - Gales, Ana C
AU - Galal, Ushma
AU - Ergonul, Onder
AU - Yong, Dongeun
AU - Yusuf, Md Abdullah
AU - Veeraraghavan, Balaji
AU - Iregbu, Kenneth Chukwuemeka
AU - van Santen, James Anton
AU - Ribeiro, Aghata Cardoso da Silva
AU - Fankhauser, Carolina Maria
AU - Chilupsya, Chisomo Judith
AU - Dolecek, Christiane
AU - Ferreira, Diogo Boldim
AU - Pinarlik, Fatihan
AU - Jang, Jaehyeok
AU - Gücer, Lal Sude
AU - Cavazzuti, Laura
AU - Sultana, Marufa
AU - Haque, M D Nazmul
AU - Haddad, Murielle Galas
AU - Medugu, Nubwa
AU - Nwajiobi-Princewill, Philip Ifeanyi
AU - Marrollo, Roberta
AU - Zhao, Rui
AU - Baskaran, Vivekanandan B
AU - Peter, J V
AU - Chandy, Sujith J
AU - Bakthavatchalam, Yamuna Devi
AU - Walsh, Timothy R
AU - COVID-19/DRI Study Group
N1 - Funding: The study is funded by Wellcome Trust (221579/Z/20/Z) and Ineos Oxford
Institute for Antimicrobial Research.
PY - 2025/4
Y1 - 2025/4
N2 - 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.
AB - 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.
UR - https://pmc.ncbi.nlm.nih.gov/articles/PMC11945301/
U2 - 10.1093/jacamr/dlaf037
DO - 10.1093/jacamr/dlaf037
M3 - Article
C2 - 40151230
SN - 2632-1823
VL - 7
SP - 1
EP - 12
JO - JAC-Antimicrobial Resistance
JF - JAC-Antimicrobial Resistance
IS - 2
M1 - dlaf037
ER -