Global antibiotic use during the COVID-19 pandemic: analysis of pharmaceutical sales data from 71 countries, 2020–2022

Nandi, Arindam; Pecetta, Simone; Bloom, David E.

doi:10.1016/j.eclinm.2023.101848

Cited by 105 publications

(64 citation statements)

References 48 publications

(66 reference statements)

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“…The observed signi cant impact of COVID-19 on antimicrobial prescription practices, is demonstrable in both short-term and long-lasting over-prescription of these drugs. These ndings are in keeping with previous reports which highlighted the potential short-and long-term effects of the pandemic on antimicrobial utilization and emergence of resistance [32][33][34][35]. Factors such as the heightened use of empiric antibiotics for COVID-19 patients, higher prescription rates of antibiotics for telemedicine consultations and adverse effect on the implementation of antibiotic stewardship programs have been identi ed [32,33].…”

Section: Discussionsupporting

confidence: 88%

Unveiling the dynamics of antimicrobial utilization and resistance in a large hospital network over five years: Insights from health record data analysis

Senok

AlDabal

Khansaheb³

et al. 2023

Preprint

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Background: Antimicrobial Resistance (AMR) presents a pressing public health challenge globally which has been compounded by the COVID-19 pandemic. Elucidation of the impact of the pandemic on AMR evolution using population-level data that integrates clinical, laboratory and prescription data remains lacking. Methods: Data was extracted from the centralized electronic platform which captures the health records of 60,551 patients across the network of public healthcare facilities in Dubai, United Arab Emirates. For all inpatients and outpatients diagnosed with bacterial infection between 01/01/2017 and 31/05/2022, structured and unstructured Electronic Health Record data, microbiological laboratory data including antibiogram, molecular typing and COVID-19 testing information as well as antibiotic prescribing data were extracted curated and linked. Various analytical methods, including time-series analysis, natural language processing (NLP) and unsupervised clustering algorithms, were employed to investigate the trends of antimicrobial usage and resistance over time, assess the impact of prescription practices on resistance rates, and explore the effects of COVID-19 on antimicrobial usage and resistance. Results: Our findings identified a significant impact of COVID-19 on antimicrobial prescription practices, with short-term and long-lasting over-prescription of these drugs. Resistance to antimicrobials increased the odds ratio of mortality to an average of 2.5 and the effects of prescription practices on resistance were observed within one week of initiation. Significant trends in antimicrobial resistance, exhibiting fluctuations for various drugs and organisms, with an overall increasing trend in resistance levels, particularly post-COVI D-19 were identified. Conclusion: This study provides a population-level insight into the evolution of AMR in the context of COVID-19 pandemic. The findings emphasize the long-term effect of COVID-19 on the AMR crisis and the critical need for improved antimicrobial stewardship to tackle AMR evolution.

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Section: Discussionsupporting

confidence: 88%

Unveiling the dynamics of antimicrobial utilization and resistance in a large hospital network over five years: Insights from health record data analysis

Senok

AlDabal

Khansaheb³

et al. 2023

Preprint

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“…Boiling milk and eggs reduces antibiotic residues. The indiscriminate and illogical use of antibiotics in cattle may leave residues in food sources and pose a major health risk to consumers if the withdrawal period F I G U R E 3 Antibiotic usage rate of different developing countries in 2018 (Browne et al, 2021;Nandi et al, 2023).…”

Section: Current Status and Exposure Assessment Of Antibiotic Residue...mentioning

confidence: 99%

“…Antibiotic usage rate of different developing countries in 2018 (Browne et al, 2021; Nandi et al, 2023). …”

Section: Current Status and Exposure Assessment Of Antibiotic Residue...mentioning

confidence: 99%

A comprehensive review on the fate and impact of antibiotic residues in the environment and public health: A special focus on the developing countries

Sikder,

Toha,

Anik

et al. 2024

Water Environment Research

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The widespread application of antibiotics in human and veterinary medicine has led to the pervasive presence of antibiotic residues in the environment, posing a potential hazard to public health. This comprehensive review aims to scrutinize the fate and impact of antibiotic residues, with a particular focus on the context of developing nations. The investigation delves into the diverse pathways facilitating the entry of antibiotics into the environment and meticulously examines their effects on human health. The review delineates the current state of antibiotic residues, evaluates their exposure in developing nations, and elucidates existing removal methodologies. Additionally, it probes into the factors contributing to the endurance and ecotoxicity of antibiotic residues, correlating these aspects with usage rates and associated mortalities in these nations. The study also investigates removal techniques for antibiotic residues, assessing their efficiency in environmental compartments. The concurrent emergence of antibiotic‐resistant bacteria, engendered by antibiotic residues, and their adverse ecological threats underscore the necessity for enhanced regulations, vigilant surveillance programs, and the adoption of sustainable alternatives. The review underlines the pivotal role of public education and awareness campaigns in promoting responsible antibiotic use. The synthesis concludes with strategic recommendations, strengthening the imperative for further research encompassing comprehensive monitoring, ecotoxicological effects, alternative strategies, socio‐economic considerations, and international collaborations, all aimed at mitigating the detrimental effects of antibiotic residues on human health and the environment.Practitioner Points Antibiotic residues are widely distributed in different environmental compartments. Developing countries use more antibiotics than developed countries. Human and veterinary wastes are one of the most responsible sources of antibiotic pollution. Antibiotics interact with biological systems and trigger pharmacological reactions at low doses. Antibiotics can be removed using modern biological, chemical, and physical–chemical techniques.

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“…Antibiotics were prescribed to 75% of COVID-19 patients, while confirmed bacterial co infection rates are less than 10%. On the above background, a meta-study of Global antibiotic use during the COVID-19 pandemic analyzed through the pharmaceutical sales data from 71 countries found a monthly 10% increase in antibiotic use-associated cases across continents including Africa, Asia, Europe, North America, and South America, which includes Cephalosporins, Macrolides, Penicillin, and Tetracyclines [21]. Another study from Turkey reported 61.8% of antibiotic use in COVID-19 patients and it includes a combination of beta-lactams, and macrolides or fluoroquinolones, and in patients in the ICU, piperacillin/tazobactam was the most prescribed antibiotic [22].…”

Section: Global Overview Of Antibiotic Use In Covid-19 Patientsmentioning

confidence: 99%

Emerging Antibiotic Resistance in Post-COVID-19 Co-infections

DAS¹

2023

J Clin Med Case Reports

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There is emerging evidence of antibiotic resistance, particularly for antibiotics commonly used to treat secondary bacterial infections in COVID-19 patients. The overuse of antibiotics in COVID-19 patients has contributed to the development of antibiotic-resistant bacterial strains against amoxicillin, azithromycin, cephalosporins, ciprofloxacin, and carbapenem. The most resistant bacteria isolated from COVID-19 patients include Klebsiella pneumonia, Acinetobacter baumannii, and Pseudomonas aeruginosa, which showed multiple antibiotic resistance. The increasing rates of antibiotic resistance are labeled as a "silent pandemic" as post covid-19 bacterial infections caused by deadly pathogens are the most significant threats to global health.

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Global antibiotic use during the COVID-19 pandemic: analysis of pharmaceutical sales data from 71 countries, 2020–2022

Cited by 105 publications

References 48 publications

Unveiling the dynamics of antimicrobial utilization and resistance in a large hospital network over five years: Insights from health record data analysis

Unveiling the dynamics of antimicrobial utilization and resistance in a large hospital network over five years: Insights from health record data analysis

A comprehensive review on the fate and impact of antibiotic residues in the environment and public health: A special focus on the developing countries

Emerging Antibiotic Resistance in Post-COVID-19 Co-infections

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