Antimicrobial consumption in patients with COVID-19: a systematic review and meta-analysis

Khan, Sidra; Hasan, Syed Shahzad; Bond, Stuart; Conway, Barbara R.; Aldeyab, Mamoon A.

doi:10.1080/14787210.2022.2011719

Cited by 61 publications

(62 citation statements)

References 66 publications

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“…However, when restricting the analysis to either ICUs or only broad-spectrum antibiotics, there was a clear increase in antibiotic consumption during both the first wave and the beginning of the second wave compared with the pre-COVID-19 period. This finding is consistent with a study showing that despite a relatively low prevalence of bacterial co-infections (3.5%) or secondary infections (14.3%) in patients with COVID-19, 58% of all hospitalized COVID-19 patients in high-income countries received at least one antibiotic [ 28 ]. Little has been published on antibiotic consumption during the different periods of the pandemic.…”

Section: Discussionsupporting

confidence: 92%

Impact of the COVID-19 Pandemic on Inpatient Antibiotic Consumption in Switzerland

et al. 2022

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The aim of this study was to analyze inpatient antibiotic consumption during the first 16 months of the COVID-19 pandemic in Switzerland. The entire period (January 2018–June 2021) was divided into the prepandemic period, the first and second waves, and the intermediate period. In the first year of the pandemic, total overall inpatient antibiotic consumption measured in defined daily doses (DDD) per 100 bed-days remained stable (+1.7%), with a slight increase in ICUs of +4.2%. The increase in consumption of broad-spectrum antibiotics was +12.3% overall and 17.3% in ICUs. The segmented regression model of monthly data revealed an increase in overall antibiotic consumption during the first wave but not during the second wave. In the correlation analysis performed in a subset of the data, a significant positive association was found between broad-spectrum antibiotic consumption and an increasing number of hospitalized COVID-19 patients (p = 0.018). Restricting this dataset to ICUs, we found significant positive correlations between the number of hospitalized COVID-19 patients and total antibiotic consumption (p = 0.007) and broad-spectrum antibiotic consumption (p < 0.001). In conclusion, inpatient antibiotic use during the different periods of the COVID-19 pandemic varied greatly and was predominantly notable for broad-spectrum antibiotics.

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Section: Discussionsupporting

confidence: 92%

Impact of the COVID-19 Pandemic on Inpatient Antibiotic Consumption in Switzerland

et al. 2022

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“…5,6 A recent meta-analysis showed that the increases in the antibiotic consumption rates were higher in lower- and middle-income countries than in high-income countries during the COVID-19 pandemic. 7 Meropenem consumption almost doubled in our hospital in 2020 (9.29 per 100 patient days; 95% CI, 9.13–9.45) compared with 2019 (5.61 per 100 patient days; 95% CI, 5.51–5.72), which was the main reason for the audit. These results demonstrate that even a limited audit and feedback can encourage more prudent use of last-resort antibiotics such as meropenem, colistin, and glycopeptides.…”

Section: Discussionmentioning

confidence: 81%

Is there still a room for improvement in antimicrobial use in a setting where use of broad-spectrum antibiotics require approval of an infectious diseases physician?

Metan

Uzun

Dizman

et al. 2022

Infect. Control Hosp. Epidemiol.

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“…Self-medication with antibiotics (SMA) has been documented to cause complications, such as adverse effects, therapeutic failure, and, most significantly, antibiotic resistance [ 4 , 5 , 6 ]. Several published studies reported on the improper antibiotic dispensing practices worldwide, an issue that is prevalent in several Eastern Mediterranean Region (EMR) countries [ 7 , 8 , 9 ]. A systematic review, that assessed antibiotics usage outside official healthcare facilities in low middle-income countries within the Middle East region, showed that the prevalence of SMA was as high as 82%, with 20% to 50% being improper usage [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…The emergence of COVID-19 in the first months of 2020 has resulted in a substantial increase in the injudicious use of antibiotics and was associated with a rise in SMA in many developing countries in an attempt to protect themselves from the virus [ 9 ]. Although antibiotics do not treat or prevent viral infections, including COVID-19, studies showed that along with the surge in infectious cases, a parallel rise in antibiotic usage was reported [ 10 , 11 , 12 , 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

Self-Medication with Antibiotics during COVID-19 in the Eastern Mediterranean Region Countries: A Review

et al. 2022

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Self-treatment with medicines including treatment with antibiotics is a growing global concern, as it can cause public health problems, such as antibiotic resistance and drug toxicity. Therefore, the significance of the self-medication impact of COVID-19 in any region can have an influence on the prevalence of such problems. The review aimed to investigate the self-treatment with antibiotics among the general population in Eastern Mediterranean region countries during COVID-19 pandemic. A comprehensive review of literature in four databases was conducted for the pandemic period from January 2020 to the end of March 2022. Nine studies related to self-treatment with antibiotics were found. The studies were homogeneous in terms of assessing the antibiotic self-treatment usage during the COVID-19 pandemic among the general population and among community pharmacies. The prevalence of self-treatment with antibiotics ranged from 20.8% to 45.8% between the studies. The main reasons for that were cost-saving, fear of COVID-19 infection, quarantine, and ease of accessibility without time limits. Antibiotic self-treatment has been high during the COVID-19 pandemic; however, it was less reported during the study period than before the time of the pandemic. There is a need for more restrictions on dispensing antibiotics from community pharmacies. In addition, there is a need to raise awareness among the population regarding self-treatment with antibiotics.

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Antimicrobial consumption in patients with COVID-19: a systematic review and meta-analysis

Cited by 61 publications

References 66 publications

Impact of the COVID-19 Pandemic on Inpatient Antibiotic Consumption in Switzerland

Impact of the COVID-19 Pandemic on Inpatient Antibiotic Consumption in Switzerland

Is there still a room for improvement in antimicrobial use in a setting where use of broad-spectrum antibiotics require approval of an infectious diseases physician?

Self-Medication with Antibiotics during COVID-19 in the Eastern Mediterranean Region Countries: A Review

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