Decrease in community antibiotic consumption during the COVID-19 pandemic, EU/EEA, 2020

Högberg, Liselotte Diaz; Vlahović‐Palčevski, Vera; Pereira, Cátia; Weist, Klaus; Monnet, Dominique

doi:10.2807/1560-7917.es.2021.26.46.2101020

Cited by 36 publications

(34 citation statements)

References 9 publications

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“…In China, the influence factors and their interaction relation of antibiotics use under the COVID-19 pandemic were becoming clear ( Figure 7 ). The shock of COVID-19 in 2020 led to significant decline in antibiotic consumption around the world ( Swedres-Svarm, 2020 ; Blix and Høye, 2021 ; Buehrle et al, 2021 ; ECDC, 2021 ; Gagliotti et al, 2021 ; Hogberg et al, 2021 ; King et al, 2021 ; Ng et al, 2021 ; Penalva et al, 2021 ; Sundhedsdatastyrelsen, 2021 ), and China is no exception. The decreases of antibiotic consumption during the COVID-19 pandemic might be due to the declined infectious diseases incidence caused by non-pharmaceutical interventions (NPIs) introduced to reduce COVID-19 transmission ( Swedres-Svarm, 2020 ; Gagliotti et al, 2021 ; Penalva et al, 2021 ; Ullrich et al, 2021 ), as well as the reduction of medical service contact and the compression of irrational prescriptions during the pandemic lockdown.…”

Section: Discussionmentioning

confidence: 99%

“…The generalized linear model (GLM) was used to examine the change of health facilities’ antibiotic consumption under the impact of the COVID-19 pandemic. According to previous studies, the impact of the COVID-19 pandemic on the use of antibiotics in medical institutions might be related to the drug treatment of COVID-19 cases ( Li et al, 2020 ; Langford et al, 2021 ) and the decline of medical services due to COVID-19 control measures ( Buehrle et al, 2021 ; ECDC, 2021 ; Hogberg et al, 2021 ; King et al, 2021 ; Ng et al, 2021 ). Thus, two variables (medical service decline and number of COVID-19 cases under treatment) were selected as the indirect measures of the COVID-19 pandemic to estimate the change of antibiotic use at the population level.…”

Section: Methodsmentioning

confidence: 99%

“…In the United States, nationwide studies reported the substantial decline of antibiotic prescribing of outpatients during the COVID-19 pandemic ( Buehrle et al, 2021 ; King et al, 2021 ). These findings from EU/EEA countries, Singapore, and the United States consistently mentioned that the significant reduction in the use of systemic antibiotics during the COVID-19 pandemic might be attributed to infection control measures and reduced contact with the health service ( Swedres–Svarm, 2020 ; Blix and Høye, 2021 ; Buehrle et al, 2021 ; ECDC, 2021 ; Gagliotti et al, 2021 ; Hogberg et al, 2021 ; King et al, 2021 ; Ng et al, 2021 ; Penalva et al, 2021 ).…”

Section: Introductionmentioning

confidence: 92%

“…The European Centre for Disease Prevention and Control (ECDC) reported that most likely as a result of the COVID-19 pandemic, the total antibiotic consumption decreased by more than 15% between 2019 and 2020 in most EU/EEA (European Union and European Economic Area) countries, mostly in primary care ( ECDC, 2021 ). The unprecedented decrease in community antibiotic consumption noted for all groups of antibiotics in nearly all EU/EEA countries is the largest in ESAC-Net (European Surveillance of Antimicrobial Consumption Network)’s two-decade long antimicrobial consumption surveillance history, and one example of the far-reaching consequences of the COVID-19 pandemic ( Hogberg et al, 2021 ). Evidence from Singapore revealed that the antimicrobial utilization in hospitals significantly reduced by 361.46 DDD/1000 patient days/month before and after the peak of the COVID-19 pandemic ( Ng et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

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Antibiotic Use in China’s Public Healthcare Institutions During the COVID-19 Pandemic: An Analysis of Nationwide Procurement Data, 2018–2020

et al. 2022

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Background: The overuse of antibiotics is a serious public health problem and a major challenge in China, and China lacks up-to-date evidence on the nationwide antibiotic use in different healthcare settings. The changes of China’s antibiotic use under the COVID-19 pandemic are still unknown.Objective: This study aimed to investigate the use of antibiotics in China’s public medical institutions based on a three-year nationwide surveillance and to examine the impact of the COVID-19 pandemic on China’s antibiotic consumption.Methods: This study used nationwide drug procurement data from the China Drug Supply Information Platform (CDSIP). We retrospectively analyzed antibiotic procurement data of 9,176 hospitals and 39,029 primary healthcare centers (PHCs) from 31 provinces in mainland China from January 2018 to December 2020. Antibiotic utilization was measured by defined daily doses (DDDs) and DDD per 1,000 inhabitants per day (DID). Generalized linear regression models were established to quantify the impact of the COVID-19 pandemic on antibiotic use.Results: The total antibiotic consumption among all healthcare settings increased from 12.94 DID in 2018 to 14.45 DID in 2019, and then dropped to 10.51 DID in 2020. More than half of antibiotics were consumed in PHCs, especially in central regions (59%–68%). The use of penicillins (J01C) and cephalosporins (J01D) accounted for 32.02% and 28.86% of total antibiotic consumption in 2020. During 2018–2020, parenteral antibiotics accounted for 31%–36% of total antibiotic consumption; the proportion is more prominent in central and western regions and the setting of hospitals. Access category antibiotics comprised 40%–42% of the total utilization. Affected by COVID-19, the antibiotic consumption was significantly dropped both in hospitals (β = −.11, p < .001) and PHCs (β = −.17, p < .001), as well as in total (β = −.14, p < .001). Significant increments were observed in the proportion of total antibiotics (β = .02, p = .024) consumed in hospitals (against the consumption in all healthcare settings), as well as parenteral antibiotics (β = 1.73, p = .001).Conclusion: The consistent preferred use of penicillin and cephalosporin, as well as injections, among China’s public healthcare institutions should draw concern. China’s antibiotic consumption significantly declined during the COVID-19 pandemic, which brings opportunities for antibiotic use management in China.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

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Antibiotic Use in China’s Public Healthcare Institutions During the COVID-19 Pandemic: An Analysis of Nationwide Procurement Data, 2018–2020

et al. 2022

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“…In addition, there could be a difference in antibiotic prescribing during remote consultations between diagnoses, i.e., studies show that antibiotics may be prescribed more frequently during remote consultations for urinary tract infections (UTIs) [11]. Moreover, since the start of the COVID-19 pandemic, a substantial decrease in antibiotic prescriptions was observed in most European countries on top of the already declining prescription rates over the last years [12]. This reduction was observed both in DGPs and OOH-services [10,13].…”

Section: Introductionmentioning

confidence: 99%

Antibiotic Prescribing in Dutch Daytime and Out-of-Hours General Practice during the COVID-19 Pandemic: A Retrospective Database Study

et al. 2022

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COVID-19 restrictions have resulted in major changes in healthcare, including the prescribing of antibiotics. We aimed to monitor antibiotic prescribing trends during the COVID-19 pandemic in Dutch general practice, both during daytime and out-of-hours (OOH). Routine care data were used from 379 daytime general practices (DGP) and 28 OOH-services over the period 2019–2021. Per week, we analyzed prescription rates per 100,000 inhabitants, overall, for respiratory and urinary tract infections (RTIs and UTIs) specifically and within age categories. We assessed changes in antibiotic prescribing during different phases of the pandemic using interrupted time series analyses. Both at DGPs and OOH-services significantly fewer antibiotics were prescribed during the COVID-19 pandemic after government measures became effective. Furthermore, the number of contacts decreased in both settings. When restrictions were revoked in 2021 prescription rates increased both at DGP and OOH-services, returning to pre-pandemic levels at OOH-services, but not in DGP. Changes in antibiotic prescribing rates were prominent for RTIs and among children up to 11 years old, but not for UTIs. To conclude, while antibiotic prescribing decreased during the first year of the COVID-19 pandemic both in daytime and out-of-hours, the pandemic does not seem to have a lasting effect on antibiotic prescribing.

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Comparison of drug prescribing before and during the COVID‐19 pandemic: A cross‐national European study

Selke-Krulichova

Selke

Bennie

et al. 2022

Pharmacoepidemiology and Drug

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Purpose The COVID‐19 pandemic had an impact on health care, with disruption to routine clinical care. Our aim was to describe changes in prescription drugs dispensing in the primary and outpatient sectors during the first year of the pandemic across Europe. Methods We used routine administrative data on dispensed medicines in eight European countries (five whole countries, three represented by one region each) from January 2017 to March 2021 to compare the first year of the COVID‐19 pandemic with the preceding 3 years. Results In the 10 therapeutic subgroups with the highest dispensed volumes across all countries/regions the relative changes between the COVID‐19 period and the year before were mostly of a magnitude similar to changes between previous periods. However, for drugs for obstructive airway diseases the changes in the COVID‐19 period were stronger in several countries/regions. In all countries/regions a decrease in dispensed DDDs of antibiotics for systemic use (from −39.4% in Romagna to −14.2% in Scotland) and nasal preparations (from −34.4% in Lithuania to −5.7% in Sweden) was observed. We observed a stockpiling effect in the total market in March 2020 in six countries/regions. In Czechia the observed increase was not significant and in Slovenia volumes increased only after the end of the first lockdown. We found an increase in average therapeutic quantity per pack dispensed, which, however, exceeded 5% only in Slovenia, Germany, and Czechia. Conclusions The findings from this first European cross‐national comparison show a substantial decrease in dispensed volumes of antibiotics for systemic use in all countries/regions. The results also indicate that the provision of medicines for common chronic conditions was mostly resilient to challenges faced during the pandemic. However, there were notable differences between the countries/regions for some therapeutic areas.

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Decrease in community antibiotic consumption during the COVID-19 pandemic, EU/EEA, 2020

Cited by 36 publications

References 9 publications

Antibiotic Use in China’s Public Healthcare Institutions During the COVID-19 Pandemic: An Analysis of Nationwide Procurement Data, 2018–2020

Antibiotic Use in China’s Public Healthcare Institutions During the COVID-19 Pandemic: An Analysis of Nationwide Procurement Data, 2018–2020

Antibiotic Prescribing in Dutch Daytime and Out-of-Hours General Practice during the COVID-19 Pandemic: A Retrospective Database Study

Comparison of drug prescribing before and during the COVID‐19 pandemic: A cross‐national European study

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