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Antibiotic prescription during the COVID-19 pandemic

Antimicrobial stewardship approaches urgently need to be reinforced during the COVID-19 pandemic. This study evaluates the impact of the COVID-19 on antibiotic consumption

Description of the Study:

  • Title: Antibiotic prescription during the COVID-19 pandemic: A biphasic pattern
  • Principal investigator: Gabriela Abelenda Alonso, Ariadna Padullés, Alexander Rombauts, Carlota Gudiol, Miquel Pujol, Claudia Alvarez Pouso, Ramón Jodar and Jordi Carratalà.
  • Centers of Implementation: Hospital Universitari de Bellvitge, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), Universitat de Barcelona and Spanish Network for Research in Infectious Diseases, Madrid.
  • Study Population: Patients admitted in Hospital Universitari de Bellvitge from January 1 to April 30 in 2019 and 2020.
  • Study Type: Before-and-after cross-sectional study.
  • Design: Before-and-after cross-sectional study comparing data in 2019 (before the COVID-19 pandemic began) and 2020 (COVID-19) for the periods from January 1 to April 30.
  • Methods: Medians for continuous variables were compared using the Wilcoxon log-rank test.

Objectives of the Study:

Principal Objective: To calculate the defined daily dose per 100 patient days, and based on the dispensing data of an electronic prescribing system.

More about this Study:

Scientific Context: The COVID-19 pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a public health problem of historic dimensions. However, this pandemic is occurring in the setting of an antimicrobial resistance crisis that is increasing at an alarming pace worldwide.

Conclusions: Standardizing immunomodulatory treatments, ensuring compliance with usual infection control practices, and carefully interpreting microbiological results will be key measures that could favor a more cautious approach to the use of antibiotics.

In this study a biphasic pattern of increased antibiotic use was identified and that corresponded with a first wave of empirical antibiotic therapy and a second biphasic pattern with higher use of broad-spectrum antibiotics.

Data support the World Health Organization concern regarding inappropriate use of antibiotics during the pandemic and the recent change in its guidelines discouraging empirical antibiotics in COVID-19.

Hospital Universitari de Bellvitge: It is a 700-bed hospital that serves as a public referral center of 1 million inhabitants in Catalonia, the second worst pandemic-affected area in Spain. As of April 30, 2020, this hospital had had >1,293 hospital admissions for COVID-19, with a 317% increase in critical care bed use.

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