Antimicrobial stewardship in the post COVID-19 pandemic era: an opportunity for renewed focus on controlling the threat of antimicrobial resistance

Mahida, Nikunj; Winzor, Gemma; Wilkinson, Mike; Jumaa, Pauline; Gray, Jim

doi:10.1016/j.jhin.2022.10.001

Cited by 6 publications

(3 citation statements)

References 32 publications

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“…Além disso, a fim de reduzir as expressivas consequências das IRAS causadas pelo grupo ESKAPE, uma pesquisa demonstrou que a limpeza à base de cloro e a implementação de um programa de conscientização do uso dos antibióticos, levou a uma redução nos índices (Mahida, et al, 2022). Outros dois estudos relataram taxas de 38,9% e 48,7% para a adesão à higiene das mãos e melhorias foram observadas após a intervenção (Nicholson, et al, 2016;Deshommes, et al, 2021).…”

Section: Discussionunclassified

Infecções secundárias causadas por bactérias do grupo ESKAPE e impacto à saúde de pacientes com complicações da Covid-19 – uma revisão integrativa

Ribeiro

Torres

Rodrigues

et al. 2022

RSD

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Introdução: A resistência bacteriana descrita para o grupo ESKAPE é uma problemática considerável para a saúde global que resulta em prejuízos sociais, econômicos e principalmente a saúde. Objetivos: Descrever os prejuízos associados à saúde de pacientes internados com complicações da COVID-19 inerentes as coinfecções causadas pelo grupo bacteriano ESKAPE. Metodologia: Trata-se de uma revisão integrativa da literatura, as buscas dos estudos foram realizadas nas bases National Library of Medicine National Institutes of Health (PubMed) e Science Direct, utilizando o método PRISMA, foram incluídos artigos publicados entre os anos de 2020 e 2021, em inglês. Resultados: A amostra contou com 17 artigos, nos quais detectou-se a ocorrência do grupo ESKAPE e prejuízos inerentes à saúde dos pacientes com COVID-19. O Staphylococcus aureus sensível à meticilina (MSSA), seguido pelo Staphylococcus aureus resistente à meticilina (MRSA), Klebsiella pneumoniae e Enterococcus spp. foram as principais bactérias relatadas. Os principais prejuízos inerentes a associação COVID-ESKAPE foram o tempo prolongado de internação, a resistência bacteriana aos antimicrobianos e pior prognóstico. Conclusão: Portanto, a associação entre a presença de bactérias do grupo ESKAPE e os prejuízos inerentes à saúde de pacientes com COVID-19 não podem ser subestimadas. Faz-se necessário dar seguimento com novos estudos, a fim de prevenir agravos e promover saúde com base nas informações sobre as principais complicações, promovendo intervenções e reduzindo a morbimortalidade desses pacientes.

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Section: Discussionunclassified

Infecções secundárias causadas por bactérias do grupo ESKAPE e impacto à saúde de pacientes com complicações da Covid-19 – uma revisão integrativa

Ribeiro

Torres

Rodrigues

et al. 2022

RSD

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“…for respiratory infections [4], and increases in antibiotic prescribing in the dental sector were attributed to restricted access to dental care [2]. Additionally, antibiotic stewardship may have been de-prioritised given pandemic-related pressures [5,6]. Therefore, there is a need to re-enforce antibiotic stewardship in the COVID-19 pandemic era.…”

Section: Introductionmentioning

confidence: 99%

Insights from Large-Scale Analysis of Long Term and Repeat Antibiotic Prescribing Pre and during the COVID-19 Pandemic Periods

Orlek¹,

Harvey²,

Fisher³

et al. 2023

Preprint

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COVID-19 pandemic-related pressures on primary care may have driven inappropriate continuation of antibiotic prescriptions. Yet prescribing modality (repeat/non-repeat) has not previously been investigated in a pandemic context. Using the OpenSAFELY-TPP analytics platform, we analysed repeat/non-repeat prescribing frequency in monthly patient cohorts between Jan 2020–2022. In-depth analysis was conducted on Jan 2020 (“pre-pandemic”) and Jan 2021 (“pandemic”) cohorts. Per-patient prescribing and clinical conditions were determined by searching primary care record data using clinical code lists. Repeat prescribing was defined as >=3 prescriptions in a 6 month lookback period. Associations between demographics (e.g. age, sex, geography) and repeat/non-repeat prescribing were explored using unadjusted risk ratios. Antibiotic prescribing declined from May 2020; non-repeat prescribing declined more strongly than repeat prescribing (maximum declines -26% vs -11%, respectively). In the pandemic cohort, older patients were at higher risk of prescribing (especially repeat prescribing). The most common clinical conditions for repeat prescribing were COPD comorbidity and urinary tract infection. Comorbidities were more common among repeat vs non-repeat prescribed patients. In the pandemic cohort, vs pre-pandemic, repeat and non-repeat prescribing for comorbidities generally declined less compared with shorter-term conditions (infections, including COPD exacerbation/lower respiratory tract infection). Our findings inform ongoing development of stewardship interventions in England..

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“…For example, general practitioners reported a lower threshold for prescribing for respiratory infections [5], and increases in antibiotic prescribing in the dental sector were attributed to restricted access to dental care [2]. Additionally, antibiotic stewardship may have been de-prioritised due to pandemic-related pressures [6,7]. Therefore, there is a need to re-enforce antimicrobial stewardship in the COVID-19 pandemic era.…”

Section: Introductionmentioning

confidence: 99%

Patient Characteristics Associated with Repeat Antibiotic Prescribing Pre- and during the COVID-19 Pandemic: A Retrospective Nationwide Cohort Study of >19 Million Primary Care Records Using the OpenSAFELY Platform

Orlek¹,

Harvey²,

Fisher

et al. 2023

Pharmacoepidemiology

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COVID-19 pandemic-related pressures on primary care may have driven the inappropriate continuation of antibiotic prescriptions. Yet, prescribing modality (repeat/non-repeat) has not previously been investigated in a pandemic context. With the approval of NHS England, we conducted a retrospective cohort study of >19 million English primary care patient records using the OpenSAFELY-TPP analytics platform. We analysed repeat/non-repeat prescribing frequency in monthly patient cohorts between January 2020 and 2022. In-depth analysis was conducted on January 2020 (“pre-pandemic”) and January 2021 (“pandemic”) cohorts (with a particular focus on repeat prescribing). Per-patient prescribing and clinical conditions were determined by searching primary care records using clinical codelists. Prescriptions in a 6-month lookback period were used to delineate repeat prescribing (≥3 prescriptions) and non-repeat prescribing (1–2 prescriptions). Associations between demographics (e.g., age, sex, ethnicity) and prescribing were explored using unadjusted risk ratios. The frequency of clinical conditions among prescribed patients was examined. Antibiotic prescribing declined from May 2020; non-repeat prescribing declined more strongly than repeat prescribing (maximum declines −26% vs. −11%, respectively). Older patients were at a higher risk of prescribing (especially repeat prescribing). Comorbidities were more common among repeat- vs. non-repeat-prescribed patients. In the pandemic cohort, the most common clinical conditions linked to repeat prescribing were COPD comorbidity and urinary tract infection. Our findings inform the ongoing development of stewardship interventions in England, targeting patient groups wherein there is a high prevalence of repeat prescribing.

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Antimicrobial stewardship in the post COVID-19 pandemic era: an opportunity for renewed focus on controlling the threat of antimicrobial resistance

Cited by 6 publications

References 32 publications

Infecções secundárias causadas por bactérias do grupo ESKAPE e impacto à saúde de pacientes com complicações da Covid-19 – uma revisão integrativa

Infecções secundárias causadas por bactérias do grupo ESKAPE e impacto à saúde de pacientes com complicações da Covid-19 – uma revisão integrativa

Insights from Large-Scale Analysis of Long Term and Repeat Antibiotic Prescribing Pre and during the COVID-19 Pandemic Periods

Patient Characteristics Associated with Repeat Antibiotic Prescribing Pre- and during the COVID-19 Pandemic: A Retrospective Nationwide Cohort Study of >19 Million Primary Care Records Using the OpenSAFELY Platform

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