Antibiotic use during the first 6 months of
            <scp>COVID</scp>
            ‐19 pandemic in Iran: A large‐scale multi‐centre study

Salehi, Mohammadreza; Khalili, Hossein; Seifi, Arash; Davoudi, Hamidreza; Darazam, Ilad Alavi; Jahangard‐Rafsanjani, Zahra; Mohammadnejad, Esmaeil; Heydari, Behrooz; Siahkaly, SaeedReza Jamali Moghadam; Tabarsi, Payam; Kalantari, Saeed; Menshadi, Seyed Ali Dehghan; Babamahmoodi, Farhang; Khorvash, Farzin; Davarpanah, Mohammad Ali; Soltani, Rasool; Yaghoobi, Mojtaba Hedayat; Anari, Seyed Alireza Mosavi; Khodadadi, Javad; Aliramezani, Amir; Hantooshzadeh, Sedigheh; Naderi, Hassan; Hajiabdolbaghi, Mahboobeh; Elyasi, Sepideh; Firouzabadi, Dena; Kasgari, Hamideh Abbaspour; Roshanzamiri, Soheil; Pharm., D Sholeh Ebrahimpour

doi:10.1111/jcpt.13761

Cited by 5 publications

(3 citation statements)

References 26 publications

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“…In the present study, we found a high overall rate of antibiotic intake, with more than half of the patients receiving some sort of antibiotic treatment during their hospital stay, and an average of 53.29 DOT/100 patient days. In a multicenter study conducted in Iran, Salehi et al found an average use of 121.6 DDD/100 hospital bed days during the first six months of the pandemic [10]. Interestingly, 74% of patients in the meta-analysis by Chedid et al received some sort of antibiotic therapy during the first wave of the pandemic [11], a rate similar to the figure of 77.6% of patients under an antibiotic treatment during the first wave in our cohort.…”

Section: Discussionsupporting

confidence: 85%

An Ocean between the Waves: Trends in Antimicrobial Consumption in Hospitalized Patients with COVID-19

Durà-Miralles,

Abelenda-Alonso,

Bergas

et al. 2024

Antibiotics

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We assessed the antibiotic use in SARS-CoV-2-infected patients during four different waves of the COVID-19 pandemic, as well as its trends over the period and associated risk factors. We performed a cross-sectional retrospective analysis nested in a prospectively collected cohort of hospitalized adult patients with COVID-19 at a university hospital in Spain. A total of 2415 patients were included in this study, among whom 1120 corresponded to the first wave. The highest percentage of patients receiving some sort of antibiotic treatment was higher during the first wave (77.6%) than during the others; nevertheless, our calculation of the average DOT (days of antibiotic treatment) per 100 patient days of stay found that the highest antibiotic prescription rate corresponded to the second pandemic wave (61.61 DOT/100 patient days), which was associated with a higher ICU admission rate and a lower SpO2/FiO2 ratio at admission. After the second wave, the prescription rates presented a steady downward trend. With regard to the use of specific antibiotic families, amoxicillin/clavulanate was the most used antibiotic in our cohort (14.20 DOT/100 patient days) due to a high prescription rate during the first wave. According to the “AWaRe” WHO classification, antibiotics corresponding to the “Watch” group were the most prescribed (27.92 DOT/100 patient days). The antibiotic use rate fell progressively, but it remained high during all four waves analyzed. In conclusion, antibiotic use was high throughout all the waves that were analyzed, despite a relatively low incidence of bacterial coinfection and superinfection. Efforts should be made to keep antimicrobial stewardship programs active, especially in complicated epidemiological situations, such as the SARS-CoV-2 pandemic.

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Section: Discussionsupporting

confidence: 85%

An Ocean between the Waves: Trends in Antimicrobial Consumption in Hospitalized Patients with COVID-19

Durà-Miralles,

Abelenda-Alonso,

Bergas

et al. 2024

Antibiotics

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“…It results from the association of molecules such as interleukins, interferons, chemokines, and TNF-α in patients with COVID-19. A significant elevation of inflammatory markers were observed in patients who received antibiotics, which Have been pointed out as a possible aggravation of the cytokine storm caused by COVID-19 [16,21,22]. Bacteria are able to successfully cause secondary infections in COVID-19 by their virulence factors, such as membrane proteins, secretory systems, adhesins, and glycoconjugates.…”

Section: Resultsmentioning

confidence: 99%

"Multidrug-Resistant Bacteria Related to Covid-19 Infection: A Minireview"

Rocha Curvelo

2024

BJSTR

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The World Health Organization recorded antimicrobial multidrug resistance as one of the biggest health risks in 2019. The inappropriate use of antibiotics results in their consequent ineffectiveness in the treatment of bacterial infections, hindering therapeutic alternatives and increasing the risk of poor prognosis. In late 2019, a single-stranded RNA zoonotic virus, SARS-CoV-2, was identified and caused the Coronavirus Disease-19 pandemic. The use of antibiotics prophylactically for secondary bacterial infections was one of the measures taken in the emergency scenario. The damage to the airways caused by these viruses and inhibition of the immune system favor bacterial adhesion and growth in the respiratory tract, the lack of knowledge of the disease and the initial symptomatic similarity between bacterial and viral infections, generating controversial diagnosis, causing concern about the impact on the worsening of the global condition of multidrug-resistant bacteria. More research aiming new treatments and control alternatives in cases of bacterial co-infection associated with COVID-19 and its possible markers is needed, as well as investigations of the possible impact of the pandemic on the global scenario of acquired multidrug resistance. Immunization of the population and individual respiratory stabilization effort and measures are still the only known protective measures. In the pandemic scenario characterized by a high use of biocidal agents, empirical and disordered use of antibiotics, decreased surveillance of resistance worldwide and overcrowding of health systems, lack of medical staff and personal protective equipment in some hospitals are factors that have contributed to the increase in antimicrobial resistance incidence. On the other hand, individual protective measures were identified as factors that reduce the incidence of infections in the community. In some countries, the increasing in the incidence of carbapenem-resistant bacteria and new genes and combinations have been reported, which may be related to the COVID-19 pandemic.

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“…COVID-19 pandemic in Iran, it was estimated that each patient received 1.21 DDDs of antibiotics every day ( 20 ). Our study highlighted the need for judicious use of antibiotics in the management of COVID-19 by strengthening antimicrobial surveillance programs.…”

Section: Discussionmentioning

confidence: 99%

Demographic and clinical characteristics and outcomes of COVID-19 patients admitted to a university hospital in the west of Iran: a retrospective study in the third wave

Jesmani¹,

Bozorgomid²,

Shadmani³

et al. 2023

Vacunas

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Antibiotic use during the first 6 months of COVID ‐19 pandemic in Iran: A large‐scale multi‐centre study

Cited by 5 publications

References 26 publications

An Ocean between the Waves: Trends in Antimicrobial Consumption in Hospitalized Patients with COVID-19

An Ocean between the Waves: Trends in Antimicrobial Consumption in Hospitalized Patients with COVID-19

"Multidrug-Resistant Bacteria Related to Covid-19 Infection: A Minireview"

Demographic and clinical characteristics and outcomes of COVID-19 patients admitted to a university hospital in the west of Iran: a retrospective study in the third wave

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