Antimicrobial Consumption among 66 Acute Care Hospitals in Catalonia: Impact of the COVID-19 Pandemic

Grau, Santiago; Hernández, Sergi; Echeverría-Esnal, Daniel; Almendral, Alexander; Ferrer, Ricard; Cáceres, Enrique Limón; Horcajada, Juan Pablo

doi:10.3390/antibiotics10080943

Cited by 43 publications

(50 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In addition, the high use of vitamins and zinc is in line with current national guidelines in Bangladesh (Box 1). However, there were concerns with the high empiric use of antibiotics (Table 2) despite, as mentioned, only a limited number of patients across ages have concomitant fungal or bacterial infections [62][63][64][65][66][67][68][69] . In addition, concerns with overuse are documented in the current national guidelines (Box 1).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Pilot Study on the Current Management of Children with COVID-19 In Hospitals in Bangladesh; Findings and Implications

Nusrat

Haque

Chowdhury

et al. 2021

Bangladesh J Med Sci

View full text Add to dashboard Cite

Objective: The focus on COVID-19 in children in low- and middle-income countries including Bangladesh has been on addressing key issues including poor vaccination rates as well as mental health issues, domestic violence and child labour. However, the focus on optimally managing children in hospitals is changing with new variants and concerns with the development of hyperinflammatory syndromes. There are also concerns with the overuse of antimicrobials to treat patients with COVID-19 in hospitals enhancing resistance rates. The Bangladesh Paediatric Association have developed guidelines to improve patient care building on national guidance. Consequently, there is a need to document the current management of children with COVID-19 in Bangladesh and use the findings for future guidance. Methods: Rapid analysis of the management of children with COVID-19 among eight private and public hospitals in Bangladesh with varying numbers of in-patient beds using purposely developed case report forms (CRFs). The CRFs were piloted before full roll-out. Results: Overall low numbers of children in hospital with COVID-19 (4.3% of in-patient beds). The majority were male (59.6%) and aged 5 years or under (63.5%). Reasons for admission included respiratory distress/ breathing difficulties with 94.2% of COVID-19 cases confirmed. All children were prescribed antibiotics empirically, typically those on the Watch list of antibiotics and administered parenterally, with only a small minority switched to oral therapy before discharge. There was appreciable prescribing of Vitamins (C and D) and zinc and encouragingly limited prescribing of other antimicrobials (antivirals, antimalarials and antiparasitic medicines). Length of stay was typically 5 to 10 days. Conclusion: Encouraging to see low hospitalisation rates and limited use of antimicrobials apart from antibiotics. Concerns with high empiric use of antibiotics and limited switching to oral formulations can be addressed by instigating antimicrobial stewardship programmes. We will be monitoring this. Bangladesh Journal of Medical Science Vol.20(5) 2021 p.188-198

show abstract

Section: Discussionmentioning

confidence: 99%

“…Having said this, we are aware of the high use of antimicrobials in hospitals including intensive care units in treating patients with COVID-19 despite only a limited number of patients have concomitant fungal or bacterial infections [62][63][64][65][66][67][68][69] . This includes hospitals in Bangladesh 70,71 .…”

Section: Introductionmentioning

confidence: 99%

Pilot Study on the Current Management of Children with COVID-19 In Hospitals in Bangladesh; Findings and Implications

Nusrat

Haque

Chowdhury

et al. 2021

Bangladesh J Med Sci

View full text Add to dashboard Cite

show abstract

“…Therefore antimicrobial monitoring use in the case of the pandemic is crucial to identify concerning signs of misuse or overuse. Studies conducted in several countries found an increase in antimicrobial consumption in ICUs during the pandemic (Guisado-Gil et al, 2020;Rawson et al, 2020;Grau et al, 2021b;Ng et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

Increased Use of Antibiotics in the Intensive Care Unit During Coronavirus Disease (COVID-19) Pandemic in a Brazilian Hospital

et al. 2021

View full text Add to dashboard Cite

Background: Microbial drug resistance is one of the biggest public health problems. Antibiotic consumption is an essential factor for the emergence and spread of multiresistant bacteria. Therefore, we aimed to analyze the antibiotics consumption in the Intensive Care Unit (ICU), identifying trends in the antibiotics use profile and microbiological isolates throughout the COVID-19 pandemic.Methods: We performed this retrospective observational study in intensive care units of a Brazilian tertiary hospital from January 2019 to December 2020. The primary outcome was antimicrobial consumption in the ICU, measured by defined daily doses (DDDs) per 100 bed-days. As a secondary outcome, bacterial infections (microbiological isolates) were calculated in the same fashion. Outcomes trends were analyzed using Joinpoint regression models, considering constant variance (homoscedasticity) and first-order autocorrelation assumptions. A monthly percent change (MPC) was estimated for each analyzed segment.Results: Seven thousand and nine hundred fifty-three patients had data available on prescribed and received medications and were included in the analyses. Overall, the use of antibiotics increased over time in the ICU. The reserve group (World Health Organization Classification) had an increasing trend (MPC = 7.24) from February to April 2020. The azithromycin consumption (J01FA) increased rapidly, with a MPC of 5.21 from January to April 2020. Polymyxin B showed a relevant increase from March to June 2020 (MPC = 6.93). The peak of the antibiotic consumption of Reserve group did not overlap with the peak of the pathogenic agents they are intended to treat.Conclusion: Overall antimicrobial consumption in ICU has increased in the context of the COVID-19 pandemic. The peaks in the antimicrobial’s use were not associated with the rise of the pathogenic agents they intended to treat, indicating an empirical use, which is especially concerning in the context of treating multidrug-resistant (MDR) infections. This fact may contribute to the depletion of the therapeutic arsenal for MDR treatment.

show abstract

“…Barrier precautions, increased focus on hygiene, environmental cleaning, patient isolation and the increased use of PPE, have certainly played an important role in preventing C. difficile transmission, despite the increased/inappropriate use of broad-spectrum antibiotics, with about 70% of patients with COVID-19 subjected to antibiotic therapy mainly for the suspected acquisition of secondary bacterial infections [ 36 , 37 ]. However, it has to be considered that some antibiotics, such as azithromycin, are more extensively used compared with others for treatment of COVID-19 patients [ [38] , [39] , [40] ]. Although treatment with any antibiotic may precede the development of CDI, certain antibiotic classes have higher rates of association and, in addition, the associated CDI risk can be different within the same class [ 41 ].…”

Section: And the Covid-19 Pandemicmentioning

confidence: 99%

Clostridioides difficile infection (CDI) during the COVID-19 pandemic

Spigaglia

2022

Anaerobe

View full text Add to dashboard Cite

The ongoing coronavirus disease (COVID-19) pandemic has dramatically tested healthcare systems around the world, with serious repercussions on the measures of prevention and control of hospital-acquired infections (HAIs). Among HAIs, Clostridioides difficile infection (CDI) represents one of the most important global public health threats. Although the full impact of the COVID-19 pandemic on CDI remains undetermined, depending on the development of the pandemic in the coming months, in this review literature studies of the last three years have been considered in order to depict the current situation, and make some considerations about possible future developments. If on the one hand, a general reduction in CDI incidence has been reported in several settings, mainly due to the extraordinary reinforcement of infection prevention measures, on the other hand, the critical circumstances experienced in many hospitals have limited the effectiveness of these measures, particularly in the intensive care units (ICUs), increasing the possibility of the occurrence of hospital-acquired CDI (HA-CDI). New concerns have arisen from the decrease in C. difficile testing and the increased use of broad-spectrum antibiotics reported during the pandemic. In particular, overuse of antibiotics and disinfectants may lead to a selection of resistant C. difficile strains not only in hospitals but also in the community. Furthermore, patients infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and patients that have survived COVID-19 may represent a new group of frail patients potentially at a higher risk of CDI, a group that could potentially increase in size due to SARS-CoV-2 evolution. In the dramatic COVID-19 era, the multifactorial nature of CDI has emerged more clearly than before, highlighting the necessity of a strong refocus on efforts to improve prevention strategies and to integrate CDI surveillance in a One Health prospective in order to curtail the public health threat posed by this infection in the next future.

show abstract

Antimicrobial Consumption among 66 Acute Care Hospitals in Catalonia: Impact of the COVID-19 Pandemic

Cited by 43 publications

References 33 publications

Pilot Study on the Current Management of Children with COVID-19 In Hospitals in Bangladesh; Findings and Implications

Pilot Study on the Current Management of Children with COVID-19 In Hospitals in Bangladesh; Findings and Implications

Increased Use of Antibiotics in the Intensive Care Unit During Coronavirus Disease (COVID-19) Pandemic in a Brazilian Hospital

Clostridioides difficile infection (CDI) during the COVID-19 pandemic

Contact Info

Product

Resources

About