Consumption of Antibiotics in Primary Care Setting before and during COVID-19 Pandemic in Republic of Srpska, Bosnia and Herzegovina

Sokolović, Dragana; Drakul, Dragana; Joksimović, Bojan; Lalović, Nenad; Avram, Nada; Milić, Marija; Nogo-Živanović, Dajana; Mijović, Biljana

doi:10.3390/antibiotics11101319

Cited by 7 publications

(6 citation statements)

References 22 publications

(35 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The year 2020 was marked by an enormous increase in the consumption of azithromycin both in outpatient and inpatient settings. These findings are similar to those reported from the surrounding areas and countries around the world ( ESAC-Net, 2022 ; Sokolović et al, 2022 ). An increase in the consumption of azithromycin could be partly explained due to its immunomodulatory and antiviral properties, in addition to its antibacterial effects ( Sultana et al, 2020 ).…”

Section: Discussionsupporting

confidence: 90%

“…In the months that followed, although knowledge about COVID-19 expanded significantly, the overlap of clinical and radiological features of COVID-19 with a bacterial infection of the respiratory tract helped to maintain the trend of increased and unnecessary antibiotic prescription. Numerous studies have reported an unjustified increase in antibiotic use during the COVID-19 pandemic, potentially accompanied by the rapid development and evolution of antibiotic resistance ( Rawson et al, 2020 ; Grau et al, 2021a ; Martinez-Guerra et al, 2021 ; Sokolović et al, 2022 ). Studies conducted so far show that the use of antibiotics in patients with COVID-19 greatly exceeds the number of proven bacterial superinfections ( Rawson et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Antibiotic consumption and antimicrobial resistance in the SARS-CoV-2 pandemic: A single-center experience

et al. 2023

Self Cite

View full text Add to dashboard Cite

Introduction: Antimicrobial resistance and the rapid spread of multiresistant bacteria represent one of the main public health problem in limited resources countries. This issue is significantly worsening since the COVID-19 pandemic due to the unreasonably increased antibiotics prescription to patients with confirmed SARS-CoV-2 infection. The aim of this study was to examine whether COVID-19 pandemic (2020, 2021) was associated with increased antibiotic consumption in inpatient and outpatient settings in the middle size urban region (Republic of Srpska/Bosnia and Herzegovina) in comparison to period before the pandemic (2019). Additionally, we aimed to determine antimicrobial resistance and the presence of multiresistant bacteria in the regional hospital (“Saint Apostol Luka” Hospital Doboj) in 2021.Methodology: The consumption of antibiotics in inpatient was calculated as Defined Daily Dose per one hundred of patient-days. The consumption of antibiotics in outpatient was calculated as Defined Daily Dose per thousand inhabitants per day. Resistance of bacteria to antibiotics is expressed as a rates and density for each observed antibiotic. The rate of resistance was calculated as a percentage in relation to the total number of isolates of individual bacteria. The density of resistance of isolated bacteria against a specific antibiotic was expressed as the number of resistant pathogens/1000 patient days.Results: Antibiotic consumption in hospital setting registered during 2019, 2020 and 2021 was as follows: carbapenems (meropenem: 0.28; 1.91; 2.33 DDD/100 patient-days, respectively), glycopeptides (vancomycin: 0.14; 1.09, 1.54 DDD/100 patient-days, respectively), cephalosporins (ceftriaxone: 6.69; 14.7; 14.0 DDD/100 patient-days, respectively) and polymyxins (colistin: 0.04; 0.25; 0.35 DDD/100 bed-days, respectively). Consumption of azithromycin increased drastically in 2020, and dropped significantly in 2021 (0.48; 5.61; 0.93 DDD/100 patient-days). In outpatient setting, an increase in the consumption of oral forms of azithromycin, levofloxacin and cefixime, as well as parenteral forms of amoxicillin-clavulanic acid, ciprofloxacin and ceftriaxone, was recorded. In 2021, antimicrobial resistance to reserve antibiotics in hospital setting was as follows: Acinetobacter baumanii to meropenem 66.0%, Klebsiella spp to cefotaxime 67.14%, Pseudomonas to meropenem 25.7%.Conclusion: Recent COVID-19 pandemic was associated with increased antibiotic consumption in inpatient and outpatient settings, with characteristic change of pattern of azithromycin consumption. Also, high levels of antimicrobial resistance to reserve antibiotics were registered in hospital setting with low prevalence of identified pathogen-directed antimicrobial prescription. Strategies toward combat antimicrobial resistance in the Doboj region are urgently needed.

show abstract

Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Antibiotic consumption and antimicrobial resistance in the SARS-CoV-2 pandemic: A single-center experience

et al. 2023

Self Cite

View full text Add to dashboard Cite

show abstract

“…The emergence of the COVID-19 pandemic has led to increased number of hospitalized patients worldwide and to the overuse of antibiotics, resulting in further worsening of AMR [ 4 ]. In Bosnia and Herzegovina (B&H) before the COVID-19 pandemic, the consumption of AB expressed in defined daily dose per thousand inhabitants was higher than in the countries of Western Europe and this difference continued to increase during the COVID-19 pandemic [ 5 ]. Unlike many European countries where the consumption of AB decreased during the COVID-19 pandemic, an increase in the consumption of AB was observed in B&H, both in inpatient and outpatient settings [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…In Bosnia and Herzegovina (B&H) before the COVID-19 pandemic, the consumption of AB expressed in defined daily dose per thousand inhabitants was higher than in the countries of Western Europe and this difference continued to increase during the COVID-19 pandemic [ 5 ]. Unlike many European countries where the consumption of AB decreased during the COVID-19 pandemic, an increase in the consumption of AB was observed in B&H, both in inpatient and outpatient settings [ 5 , 6 ]. In addition to the excessive and often unjustified use of AB in human medicine, the use of these drugs in veterinary medicine, agriculture, and food production contributes to the development and spread of resistance [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Public Knowledge, Attitudes, and Practices towards Antibiotic Use and Antimicrobial Resistance in Eastern Region of Bosnia and Herzegovina in the COVID-19 Pandemic

Drakul,

Joksimović,

Milić

et al. 2023

Antibiotics

Self Cite

View full text Add to dashboard Cite

The constant worsening of antimicrobial resistance (AMR) imposes the need for an urgent response. Use of antibiotics (AB), both due to irrational prescribing by doctors and irrational use by patients, is recognized as one of the leading causes of this problem. This study aimed to identify knowledge, attitudes, and practices about AB use and AMR within the general population, stratified by age, gender, and urban/rural areas during the COVID-19 pandemic. This questionnaire-based cross-sectional study was conducted in April 2022 among patients who visited three health centers in the eastern region of Bosnia and Herzegovina. A high frequency of AB use was observed during the COVID-19 pandemic (64.2% of respondents were treated with AB). Age and place of residence have not been shown to be factors associated with AB use practices that pose a risk for AMR. However, female gender (β = 0.063; p = 0.041), better knowledge (β = 0.226; p < 0.001), and positive attitudes (β = 0.170; p < 0.001) about use of AB and towards to AMR proved to be factors associated with better practice by respondents. Women, younger respondents, and respondents from urban areas showed better knowledge, attitudes, and behavior about the use of AB and AMR during the COVID-19 pandemic.

show abstract

“…Given the elevated use of antibiotics in 2020 due to the coronavirus disease (COVID-19) pandemic and low AMR resilience in many countries, this number has potentially increased in recent years. Recently published data indicate that the mortality rate increased in COVID patients who received antibiotics [ 12 , 13 ]. A recent study based on metagenomic sequencing of 757 sewage samples from 243 cities in 101 countries suggested that certain geographies are more prone to transmission events and should receive additional attention [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical Diagnostics of Bacterial Infections and Their Resistance to Antibiotics—Current State and Whole Genome Sequencing Implementation Perspectives

2023

View full text Add to dashboard Cite

Antimicrobial resistance (AMR), defined as the ability of microorganisms to withstand antimicrobial treatment, is responsible for millions of deaths annually. The rapid spread of AMR across continents warrants systematic changes in healthcare routines and protocols. One of the fundamental issues with AMR spread is the lack of rapid diagnostic tools for pathogen identification and AMR detection. Resistance profile identification often depends on pathogen culturing and thus may last up to several days. This contributes to the misuse of antibiotics for viral infection, the use of inappropriate antibiotics, the overuse of broad-spectrum antibiotics, or delayed infection treatment. Current DNA sequencing technologies offer the potential to develop rapid infection and AMR diagnostic tools that can provide information in a few hours rather than days. However, these techniques commonly require advanced bioinformatics knowledge and, at present, are not suited for routine lab use. In this review, we give an overview of the AMR burden on healthcare, describe current pathogen identification and AMR screening methods, and provide perspectives on how DNA sequencing may be used for rapid diagnostics. Additionally, we discuss the common steps used for DNA data analysis, currently available pipelines, and tools for analysis. Direct, culture-independent sequencing has the potential to complement current culture-based methods in routine clinical settings. However, there is a need for a minimum set of standards in terms of evaluating the results generated. Additionally, we discuss the use of machine learning algorithms regarding pathogen phenotype detection (resistance/susceptibility to an antibiotic).

show abstract

Consumption of Antibiotics in Primary Care Setting before and during COVID-19 Pandemic in Republic of Srpska, Bosnia and Herzegovina

Cited by 7 publications

References 22 publications

Antibiotic consumption and antimicrobial resistance in the SARS-CoV-2 pandemic: A single-center experience

Antibiotic consumption and antimicrobial resistance in the SARS-CoV-2 pandemic: A single-center experience

Public Knowledge, Attitudes, and Practices towards Antibiotic Use and Antimicrobial Resistance in Eastern Region of Bosnia and Herzegovina in the COVID-19 Pandemic

Clinical Diagnostics of Bacterial Infections and Their Resistance to Antibiotics—Current State and Whole Genome Sequencing Implementation Perspectives

Contact Info

Product

Resources

About