Impact of the pandemic on antimicrobial consumption patterns

Silva, Cristófer Farias da; Deutschendorf, Caroline; Nagel, Fabiano Marcio; Dalmora, Camila Hubner; Santos, Rodrigo Pires dos; Lisboa, Thiago

doi:10.1017/ice.2020.1227

Cited by 13 publications

(13 citation statements)

References 6 publications

(4 reference statements)

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“…In addition, it should be noted that the current study was conducted before the COVID-19 pandemic was declared. Nevertheless, we consider that the results obtained for the most prescribed antibiotics present similarities to those obtained by recent studies performed in Brazilian ICUs ( da Silva et al, 2021 ; Porto et al, 2020 ; Silva et al, 2021 ). In all cases, meropenem and piperacillin + tazobactam were among the most prescribed antibiotics.…”

Section: Discussionsupporting

confidence: 80%

“…In all cases, meropenem and piperacillin + tazobactam were among the most prescribed antibiotics. In addition, other antibiotics that are among our DU90 were found among the most prescribed antibiotics of these studies: vancomycin, cefepime ( da Silva et al, 2021 ), ceftriaxone and vancomycin ( Porto et al, 2020 ), tigecycline, polymyxin B, amoxicillin/clavulanate and amikacin ( Silva et al, 2021 ). In the Point Prevalence Survey performed in 53 countries in 2015 ( Versporten et al, 2018 ), the most prescribed antimicrobials were penicillins with a β-lactamase inhibitor, mainly piperacillin and amoxicillin.…”

Section: Discussionmentioning

confidence: 87%

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Antibiotic Consumption and Deviation of Prescribed Daily Dose From the Defined Daily Dose in Critical Care Patients: A Point-Prevalence Study

et al. 2022

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Background: The consumption of antibiotics is one of the metrics used to evaluate the impact of antimicrobial stewardship programs (ASP). The aim of this study was to determine the prevalence of antibiotic consumption in Brazilian intensive care units (ICUs) and estimate the deviation of the prescribed daily dose (PDD) from the defined daily dose (DDD).Methods: This is a multicenter, observational, point-prevalence study carried out in adult ICUs of 8 Brazilian hospitals from August 2019, to February 2020. We collected data on the patient’s demographic and clinical characteristics, antibiotic therapy, classification and site of infections. The DU90 (antibiotic accounting for 90% of the volume utilized) was calculated, and the antibiotics were classified by the Anatomical Therapeutic Chemical (ATC) Index and the World Health Organization (WHO) Access, Watch, Reserve (AWaRe) groups. For the most prevalent antibiotics, the deviation of PDD from DDD was determined.Results: Three hundred thirty-two patients from 35 ICUs were analyzed. The prevalence of antibiotic use was 52.4%. The patients in use of antibiotics were predominantly over 60 years of age (81.6%) with pulmonary infections (45.8%). A predominance of empirical regimens was observed (62.6%) among antibiotic therapies. The highest frequencies of prescriptions observed were for piperacillin + tazobactam (16.1%), meropenem (13.3%), amoxicillin + clavulanate (7.2%), azithromycin (7.2%), and teicoplanin (6.1%). The watch (64.2%) and reserve (9.6%) categories of the AWaRe classification accounted for 73.8% of all antibiotics, and they were prescribed alone or in combinations. High variability of doses was observed for the most prescribed antibiotics, and large deviations of PDD from the DDD were observed for meropenem, teicoplanin, and tigecycline.Conclusions: The high prevalence of antibiotic prescription was related to a predominance of empirical regimens and antibiotics belonging to the WHO Watch classification. High variability of doses and large deviations of PDD from DDD for meropenem, teicoplanin, and tigecycline was observed, suggesting that DDD may be insufficient to monitor the consumption of these antibiotics in the ICU population. The variability of doses found for the most prescribed antibiotics suggests the need for monitoring and intervention targets for antibiotic stewardship teams.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 87%

Antibiotic Consumption and Deviation of Prescribed Daily Dose From the Defined Daily Dose in Critical Care Patients: A Point-Prevalence Study

et al. 2022

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“…Amoxicillin is commonly prescribed by dental practitioners [ 20 ]. Self-medication with Azithromycin is probably related to the primary assumptions of patients regarding the effectiveness of this antibiotic against the coronavirus [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

A cross-sectional study on COVID-19-related changes in self-medication with antibiotics

2022

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Background and aim Dental treatments have been limited to emergency care in many countries worldwide due to the global rapid spread of coronavirus disease-2019 (COVID-19). Fear of contracting the disease in dental clinics has also altered the pattern of dental visits and self-medication. The present study compared self-medication with antibiotics (SMA) and the pattern of dental visits before and after the emergence of COVID-19 pandemic in a referral dental clinic in the north of Iran. Materials and methods The data for the present cross-sectional study was collected from 756 patient records retrieved from the archives of the Faculty Clinic of Rasht School of Dentistry during two separate periods: before the COVID-19 pandemic from mid-November 2019 to mid-February 2020, and after the pandemic emergence from mid-April to mid-July 2020. In addition to demographic variables namely age, gender, and place of residence of patients, their smoking status, chief complaint, and SMA were also extracted from patient records. The Chi-square test and binary logistic regression models with 95% confidence interval served for statistical analysis. Results In total, 756 patient records (412 records from the pre-pandemic period and 344 records from the post-pandemic period) were evaluated. SMA was significantly more prevalent after the pandemic compared to that before pandemic (OR = 3.39, 95% CI = 2.43–4.73, P<0.001). The number of patients who smoke significantly decreased after the pandemic by 6.6% compared to that in pre-pandemic period. Dental pain, pus discharge, and abscess as the chief complaints of patients were significantly more prevalent during the post-pandemic period; while, dental checkups, tooth hypersensitivity, and esthetic dental problems were significantly more frequent as the chief complaints of patients during the pre-pandemic period. Conclusion There is indication that during the COVID-19 pandemic, SMA and prevalence of acute dental problems in patients have increased. With regard to the consequences of SMA, there is a need to raise public awareness on this matter.

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“…Da Silva et al evaluated antimicrobial consumption in Brazil and found a 2500% higher rate of azithromycin consumption. Moreover, the usage of amoxicillin/clavulanate had a notably higher rate in all COVID-19 clusters (Da Silva et al 2021 ). In Athens, Greece, the use of antiviral drugs increased 170%, hydroxychloroquine increased 387%, antibiotics increased 57%, and paracetamol increased 198% (Galani et al 2021 ).…”

Section: Pharmaceutical Drugs Used In the Sars-cov-2 Pandemic: Chemic...mentioning

confidence: 99%

SARS-CoV-2 pharmaceutical drugs: a critical review on the environmental impacts, chemical characteristics, and behavior of advanced oxidation processes in water

Castañeda-Juárez

Linares-Hernández

Martínez-Miranda

et al. 2022

Environ Sci Pollut Res

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This review summarizes research data on the pharmaceutical drugs used to treat the novel SARS-CoV-2 virus, their characteristics, environmental impacts, and the advanced oxidation processes (AOP) applied to remove them. A literature survey was conducted using the electronic databases Science Direct, Scopus, Taylor & Francis, Google Scholar, PubMed, and Springer. This complete research includes and discusses relevant studies that involve the introduction, pharmaceutical drugs used in the SARS-CoV-2 pandemic: chemical characteristics and environmental impact, advanced oxidation process (AOP), future trends and discussion, and conclusions. The results show a full approach in the versatility of AOPs as a promising solution to minimize the environmental impact associated with these compounds by the fact that they offer different ways for hydroxyl radical production. Moreover, this article focuses on introducing the fundamentals of each AOP, the main parameters involved, and the concomitance with other sources and modifications over the years. Photocatalysis, sonochemical technologies, electro-oxidation, photolysis, Fenton reaction, ozone, and sulfate radical AOP have been used to mineralize SARS-CoV-2 pharmaceutical compounds, and the efficiencies are greater than 65%. According to the results, photocatalysis is the main technology currently applied to remove these pharmaceuticals. This process has garnered attention because solar energy can be directly utilized; however, low photocatalytic efficiencies and high costs in large-scale practical applications limit its use. Furthermore, pharmaceuticals in the environment are diverse and complex. Finally, the review also provides ideas for further research needs and major concerns. Graphical abstract

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Impact of the pandemic on antimicrobial consumption patterns

Cited by 13 publications

References 6 publications

Antibiotic Consumption and Deviation of Prescribed Daily Dose From the Defined Daily Dose in Critical Care Patients: A Point-Prevalence Study

Antibiotic Consumption and Deviation of Prescribed Daily Dose From the Defined Daily Dose in Critical Care Patients: A Point-Prevalence Study

A cross-sectional study on COVID-19-related changes in self-medication with antibiotics

SARS-CoV-2 pharmaceutical drugs: a critical review on the environmental impacts, chemical characteristics, and behavior of advanced oxidation processes in water

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