Evolution of Antimicrobial Consumption During the First Wave of COVID-19 Pandemic

Abstract

Background: The first wave of COVID-19 pandemic may have significantly impacted antimicrobial consumption in hospitals. The objective of this study was to assess the evolution of antimicrobial consumption during this period. Methods: A retrospective quasi-experimental before–after study was conducted in a Spanish tertiary care hospital. The study compared two periods: pre-pandemic, from January 2018 to February 2020, and during the COVID-19 pandemic from March to June 2020. Antimicrobial consumption was analyzed monthly as defined daily doses (DDD)/100 bed-days and overall hospital and ICU consumption were evaluated. Results: An increase in the hospital consumption was noticed. Although only ceftaroline achieved statistical significance (p = 0.014), a rise was observed in most of the studied antimicrobials. A clear temporal pattern was detected. While an increase in ceftriaxone and azithromycin was observed during March, an increment in the consumption of daptomycin, carbapenems, linezolid, ceftaroline, novel cephalosporin/β-lactamase inhibitors or triazoles during April–May was noticed. In the ICU, these findings were more evident, namely ceftriaxone (p = 0.029), carbapenems (p = 0.002), daptomycin (p = 0.002), azithromycin (p = 0.030), and linezolid (p = 0.011) but followed a similar temporal pattern. Conclusion: An increase in the antimicrobial consumption during the first wave of COVID-19 pandemic was noticed, especially in the ICU. Availability of updated protocols and antimicrobial stewardship programs are essential to optimize these outcomes.

An Assessment of the Impact of Coronavirus Disease (COVID-19) Pandemic on National Antimicrobial Consumption in Jordan

“…On the other hand, there was increased use of other antibiotics compared with the pre-COVID-19 period (i.e., third-generation cephalosporins, carbapenems, macrolides, and lincosamides). Similar findings were observed in other studies [17,[23][24][25]. This increase is of importance since their use has been linked to the development of resistance in several studies [1,[4][5][6]26].…”

“…The coronavirus disease 2019 (COVID-19) pandemic has led to growing concern over an increased consumption of antimicrobials for COVID-19 patients, often inappropriately used, and its relation to potentially propagating antimicrobial resistance (AMR) in the short and long term [17,18]. This is particularly an issue in low-and middle-income countries (LMIC) as cost-effective, clinical or biologic markers that effectively discriminate between bacterial and viral infections are lacking [19].…”

“…Effective diagnostic specimens for conducting mass testing and for accurate diagnosis of COVID-19 is critical and deemed necessary [14]. The inappropriate use of antibiotics during the COVID-19 pandemic may further worsen the situation in relation to antimicrobial resistance [15][16][17]. An assessment to determine changes in antimicrobial consumption due the COVID-19 outbreak is needed.…”

Phytochemical Profiling of Lavandula coronopifolia Poir. Aerial Parts Extract and Its Larvicidal, Antibacterial, and Antibiofilm Activity Against Pseudomonas aeruginosa

“…To prevent these negative outcomes and secondary bacterial infections, patients with serious illness are treated with antibiotics. As a result, the use of antibiotics has increased, and this will significantly elevate the antibiotic resistance rates [61]. Plant extracts, with diverse secondary metabolites and several molecular targets, alone or as an adjuvant therapy, would not only boost the overall antimicrobial properties but can also work as modifying/modulating agents.…”

Appropriate use of Antimicrobial Therapy For COVID-19 Co-Infection

“…All the above findings indicated that the inappropriate use of antibiotic during COVID-19 pandemic is obvious [ 17 ]. Because antibiotic overuse can result in the increasing consumption of antibiotics and cause the collateral damage – increasing antimicrobial resistance [ 18 , 19 ], how to avoid the inappropriate use of antimicrobial agents has become another great challenge. Continuing implementation of antibiotic stewardship program in optimizing the antimicrobial therapy among hospitalized COVID-19 patients could be a possible solution.…”