4CPS-246 Coronavirus first wave effect on antibiotic consumption and antimicrobial resistance

Abstract

month due to an infectious process and 7 of these patients were readmitted. 36 (57%) patients had taken antibiotics within 3 months before the study. The most common illnesses were community acquired pneumonia (CAP) 16 (25.4%), acute bronchitis (AB) 15 (23.8%), COPD exacerbation 13 (20.6%) and influenza 7 (11.1%). The most common antimicrobials prescribed were: cephalosporins 24 (26.7%), co-amoxiclav 20 (22.2%) and quinolones 17 (18.9%). Patients with AB were not analysed because there is no optimal duration of antibiotic treatment recommended in the current scientific evidence. The remainder of the patients were analysed (48): 35 were given antibiotics for more days than the recommended evidence (15 CAP, 12 COPD exacerbation, 4 influenza, 4 other infections); 9 patients were given antibiotics as per the recommended duration (3 acute pyelonephritis, 3 influenza, 1 CAP, 1 hospital acquired pneumonia, 1 complicated cystitis); and 4 were given antibiotics for a shorter duration than recommended (1 complicated cystitis, 1 COPD exacerbation, 1 pharyngotonsillitis, 1 acute gastroenteritis). Conclusion and relevance Nearly 75% of patients had a longer antibiotic course than the recommended evidence. This should be a priority for intervention. It is important to create antibiotic awareness, where 'shorter is better' is a 'prescriber mantra' as far as the rational use of antibiotics is concerned.

Effect of the COVID-19 pandemic on antibiotic consumption: A systematic review comparing 2019 and 2020 data

“…The coronavirus disease (COVID-19) pandemic has impacted many aspects of our daily lives, including economics ( 5 ), social healthcare ( 6 ), and healthcare services ( 7 , 8 ). A number of studies have reported an immediate increase in antibiotic use during the first wave of COVID-19 ( 9 – 11 ). This was partly because of 1) the treatment of bacterial coinfection among COVID-19 patients ( 10 , 12 ) and 2) the extra workload for infectious disease professionals, resulting in the interruption of antibiotic stewardship programs ( 13 ).…”

Co-Infection of SARS-CoV-2 and Klebsiella pneumoniae: A Systematic Review and Meta-Analysis

“…Subsequent studies have provided insights into the evolving epidemiology of coinfections over time, with fluctuating rates observed across different phases of the pandemic. While initial waves may have been characterized by higher rates of coinfections due to overwhelmed healthcare systems and nosocomial transmission, subsequent phases with improved infection control measures and vaccination efforts may have led to reduced rates of bacterial coinfection [ 29 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 ].…”

“…In the first year of the pandemic, four reports worldwide indicated 13% of co-infections caused by SARS-CoV-2 and Klebsiella pneumoniae [ 26 , 43 , 49 , 58 ]. In the second year of the pandemic, 13 publications reported 11% of coinfections caused by Klebsiella pneumoniae [ 29 , 31 , 32 , 35 , 39 , 40 , 44 , 47 , 51 , 52 , 54 , 56 , 57 ].…”

“…The extraction was carried out by independent authors (Table 1). [31] 2021 Spain retrospective study Moradi et al [32] 2021 Iran cross-sectional study Ahamed et al [23] 2022 Pakistan cross-sectional study Baskaran et al [33] 2022 England retrospective cohort study Bhagawati et al [34] 2022 India retrospective study Garcia-Vidal [35] 2021 Spain observational cohort study Giugliano et al [36] 2022 Italy cross-sectional study Hateet [37] 2022 Iraq prospective study Husain et al [38] 2022 France retrospective observational study Khurana et al [39] 2021 India cross-sectional study Ma Shengli et al [40] 2021 China Cohort study Mahmoudi [26] 2020 Iran cross-sectional study Mares , et al [41] 2022 Romania cross-sectional retrospective study Marua et al [42] 2022 India cross-sectional study Massey et al [43] 2020 EUA prospective study Miao et al [44] 2021 China retrospective study Moreno-García et al [45] 2022 Spain observational cohort study Ng et al [46] 2022 Singapore observational cohort study Pourajam et al [28] 2022 Iran retrospective cohort study Prado et al [47] 2022 Spain cross-sectional study Rafat et al [48] 2022 Iran cross-sectional study Ramadan et al [49] 2020 Egypt prospective study Ramzan et al [50] 2022 Pakistan retrospective study Raychaudhuri et al [51] 2021 India prospective observational study Rothe et al [52] 2021 Germany retrospective cohort study Said et al [53] 2022 Saudi Arabia retrospective cross-sectional study Salamat et al [54] 2021 Philippines retrospective study Sathyakamala et al [55] 2022 India retrospective observational study Sharma et al [29] 2021 India prospective and observational study Singh et al [56] 2021 EUA retrospective cohort study Yang et al [57] 2021 China retrospective observational st...…”

“…However, the wide confidence interval suggests some uncertainty in the precise estimate, highlighting the need for further research to refine our understanding of co-infection patterns in this region (Figure 3). [25,31,33,35,36,38,41,43,45,47,49,52,56].…”