A point prevalence survey to assess antibiotic prescribing in patients hospitalized with confirmed and suspected coronavirus disease 2019 (COVID-19)

Tan, Si Hui; Ng, Tat Ming; Tay, Hui Lin; Yap, Min Yi; Heng, Shi Thong; Loo, Audrey Yong Xin; Teng, Christine B; Lee, Tau Hong

doi:10.1016/j.jgar.2020.11.025

Cited by 24 publications

(24 citation statements)

References 5 publications

(3 reference statements)

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“…Hence, it could not be ascertained whether the antibiotic usage was high or not, especially without a proper control group any argument in favor or against would be flawed. Nevertheless, a PPS conducted in different hospitals in Scotland and Singapore during April 2020 revealed at least one antimicrobial, which included antivirals and antifungals, was prescribed in 38.3% and 6.2% hospitalized SARS-CoV-2 positive patients (which included critical care units) respectively [ 8 , 9 ]. There is a well-functioning Scottish Antimicrobial Prescribing Group (SAPG), established in 2008, tasked with overseeing the pattern of antimicrobial usage in Scottish hospitals and implement antimicrobial stewardship programs in different hospitals [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Antibiotic Prescribing Patterns at COVID-19 Dedicated Wards in Bangladesh: Findings from a Single Center Study

Molla¹,

Yeasmin²,

Islam

et al. 2021

Infection Prevention in Practice

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Background: As evidence is mounting regarding irrational and often unnecessary use of antibiotics during the COVID-19 pandemic a cross-sectional Point Prevalence Survey (PPS) (in accordance with WHO guideline) was conducted across COVID-19 dedicated wards in Dhaka Medical College and Hospital (DMCH). Methodology: Antibiotic usage data were collected from 193 patients at different COVID-19 dedicated wards at DMCH on 11 June 2020. Comparisons in antibiotic usage were made between different groups using Pearson chi-square and Fisher’s exact test. Result: Findings reveal all surveyed patients (100%) were receiving at least one antibiotic with 133 patients (68.91%) receiving multiple antibiotics. Overall, patients presenting with the severe disease received more antibiotics. Third-generation cephalosporins (i.e. ceftriaxone) (53.8%), meropenem (40.9%), moxifloxacin (29.5%), and doxycycline (25.4%) were the four most prescribed antibiotics among surveyed patients. Diabetes mellitus (DM) was independently associated with multiple antibiotic prescribing. Abnormal C-reactive protein (CRP) and serum d-dimer were linked with higher odds of multiple antibiotic prescribing among study patients. Conclusion: Prevalence of multiple antibiotic prescriptions was high among severely ill patients and those with abnormal CRP and d-dimer levels. Data regarding the quality of antibiotic prescribing were lacking.

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Section: Discussionmentioning

confidence: 99%

Antibiotic Prescribing Patterns at COVID-19 Dedicated Wards in Bangladesh: Findings from a Single Center Study

Molla¹,

Yeasmin²,

Islam

et al. 2021

Infection Prevention in Practice

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“…In a point prevalence survey from Singapore, only 6.2% of patients were on antibiotics at the time of the survey, but still the authors concluded that 40.5% of these were inappropriately prescribed. They also described that the antibiotics were more appropriately prescribed when reviewed by an infectious disease specialist than by non- infectious disease physicians [ 21 ]. This high intensity ASP approach is different from some of the published data where ASPs were suspended during the pandemic leading to higher antibiotic consumption [ 3 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

Antibiotic Use during the COVID-19 Pandemic in a Tertiary Hospital with an Ongoing Antibiotic Stewardship Program

et al. 2021

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During the recent pandemic, the fact that the clinical manifestation of COVID-19 may be indistinguishable from bacterial infection, as well as concerns of bacterial co-infection, have been associated with an increased use of antibiotics. The objective of this study was to assess the effect of targeted antibiotic stewardship programs (ASP) on the use of antibiotics in designated COVID-19 departments and to compare it to the antibiotic use in the equivalent departments in the same periods of 2018 and 2019. Antibiotic consumption was assessed as days of treatment (DOT) per 1000 patient days (PDs). The COVID-19 pandemic was divided into three periods (waves) according to the pandemic dynamics. The proportion of patients who received at least one antibiotic was significantly lower in COVID-19 departments compared to equivalent departments in 2018 and 2019 (Wave 2: 30.2% vs. 45.6% and 44.9%, respectively; Wave 3: 30.5% vs. 47.8% and 50.1%, respectively, p < 0.001). The DOT/1000PDs in every COVID-19 wave was lower than during similar periods in 2018 and 2019 (179-282 DOT/1000PDs vs. 452-470 DOT/1000PDs vs. 426-479 DOT/1000PDs, respectively). Moreover, antibiotic consumption decreased over time during the pandemic. In conclusion, a strong ASP is effective in restricting antibiotic consumption, particularly for COVID-19 which is a viral disease that may mimic bacterial sepsis but has a low rate of concurrent bacterial infection.

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“…An analysis showed that such practice resulted in 59 days of inappropriate antibiotic use. Moreover, suspected cases were started on antibiotics more frequently compared to confirmed cases of COVID-19 [ 41 ].…”

Section: Antibiotic Prescribing For Covid-19 and The Unnecessary Umentioning

confidence: 99%

Implications of COVID-19 Pandemic on the Emergence of Antimicrobial Resistance: Adjusting the Response to Future Outbreaks

Rušić

Vilović

Bukic

et al. 2021

Life

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The net effect of the coronavirus disease 2019 (COVID-19) pandemic and the response to it on the emergence of antimicrobial resistance is yet unknown. Positive impacts on the spread of multiresistant pathogens and infections in general may be observed with the implementation of general preventative measures for the spread of infectious disease such as social distancing, reduced travel and increased personal hygiene. This pandemic has accelerated the development of novel technologies, such as mRNA vaccines, that may be used to fight other diseases. These should be capitalized upon to manage the ongoing antimicrobial resistance pandemic in the background. However, it is likely that the COVID-19 pandemic is fueling the emergence of antimicrobial resistance due to high rates of inappropriate antimicrobial prescribing, the high use of biocides and the interruption of treatment for other conditions. Clinical uncertainty driven by the lack of effective diagnostics and practice of telemedicine may have driven the inappropriate use of antimicrobials. As pathogens know no borders, increased focus is needed for infectious diseases still threatening low- and middle-income countries such as tuberculosis. Stewardship measures for future outbreaks should stress the importance of social distancing and hand washing but discourage the overuse of disinfectants and antimicrobials that are not proven effective.

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A point prevalence survey to assess antibiotic prescribing in patients hospitalized with confirmed and suspected coronavirus disease 2019 (COVID-19)

Cited by 24 publications

References 5 publications

Antibiotic Prescribing Patterns at COVID-19 Dedicated Wards in Bangladesh: Findings from a Single Center Study

Antibiotic Prescribing Patterns at COVID-19 Dedicated Wards in Bangladesh: Findings from a Single Center Study

Antibiotic Use during the COVID-19 Pandemic in a Tertiary Hospital with an Ongoing Antibiotic Stewardship Program

Implications of COVID-19 Pandemic on the Emergence of Antimicrobial Resistance: Adjusting the Response to Future Outbreaks

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