Marked Reductions in Pediatric Outpatient Antibiotic Prescribing in Portugal During the Pandemic

Abstract

The COVID-19 pandemic brought unexpected effects on healthcare systems access and usage. Some of the measures implemented by governments to try and contain it, such as confinement periods, social distancing, widespread use of masks and other hygiene practices led to unprecedented epidemiological changes in several common infectious diseases.We describe changes in antibiotic prescribing in pediatric outpatients before and during the pandemic in a dynamic population analysis context during a study period of three years in mainland Portugal.There was a marked reduction in antimicrobial prescribing in all regions, particularly in younger children and during the lockdown periods.This reduction was much sharper for those antimicrobials most commonly used to treat respiratory-tract infections, as Amoxicillin (with and without β-lactamase inhibitor) and Macrolides, and considerable less accentuated in other commonly prescribed antibiotics as Co-Trimoxazole and Fosfomycin, usually associated with the treatment of urinary tract infections.Conclusion: Our findings indicate that the COVID-19 pandemic has had profound effects on antibiotic use in ambulatory care in children in Portugal.Further monitoring is necessary to ascertain whether this reduction in antibiotic prescription will persist and whether these changes may impact antimicrobial resistance.