Impact of the COVID-19 Pandemic on Initiation of Antibiotic Treatment After Performing a Blood Culture and Intervention by the Antimicrobial Stewardship Team

Sanae Kubota,1 Hiroshi Sasano,2,3 Mai Suzuki,3 Yukiko Fukui,3 Masayoshi Chonan,4 Takaaki Kawakami,4 Yoko Tabe,5 Takashi Miida,5 Toshimi Kimura,1 Toshio Naito3 1Department of Pharmacy, Juntendo University Hospital, Tokyo, Japan; 2Department of Pharmacy, Juntendo Tokyo Koto Geriatric Medical Center, T...

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Main Authors: Kubota S, Sasano H, Suzuki M, Fukui Y, Chonan M, Kawakami T, Tabe Y, Miida T, Kimura T, Naito T
Format: Article
Language:English
Published: Dove Medical Press 2023-08-01
Series:International Journal of General Medicine
Subjects:
Online Access:https://www.dovepress.com/impact-of-the-covid-19-pandemic-on-initiation-of-antibiotic-treatment--peer-reviewed-fulltext-article-IJGM
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author Kubota S
Sasano H
Suzuki M
Fukui Y
Chonan M
Kawakami T
Tabe Y
Miida T
Kimura T
Naito T
author_facet Kubota S
Sasano H
Suzuki M
Fukui Y
Chonan M
Kawakami T
Tabe Y
Miida T
Kimura T
Naito T
author_sort Kubota S
collection DOAJ
description Sanae Kubota,1 Hiroshi Sasano,2,3 Mai Suzuki,3 Yukiko Fukui,3 Masayoshi Chonan,4 Takaaki Kawakami,4 Yoko Tabe,5 Takashi Miida,5 Toshimi Kimura,1 Toshio Naito3 1Department of Pharmacy, Juntendo University Hospital, Tokyo, Japan; 2Department of Pharmacy, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan; 3Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan; 4Department of Clinical Laboratory, Juntendo University Hospital, Tokyo, Japan; 5Department of Clinical Laboratory Medicine, Juntendo University Faculty of Medicine, Tokyo, JapanCorrespondence: Hiroshi Sasano, Department of General Medicine, Juntendo University Faculty of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan, Tel +81 03-5802-1190, Email hsasano@juntendo.ac.jpPurpose: Whether the coronavirus disease 2019 (COVID-19) pandemic had any effect on the time between blood culture collection and administration of antibiotics in the outpatient Department of Emergency Medicine in a single university hospital in Japan was investigated, and the intervention carried out by the antimicrobial stewardship team (AST) to promote the appropriate use of antibiotics was examined.Patients and Methods: The monthly percentage of patients who visited the outpatient Department of Emergency Medicine between January 2019 and December 2021 and received an intravenous antibiotic within 3 hours of blood culture collection was calculated. The AST calculated a quality indicator (QI) based on the results of the investigation and started QI monitoring and hospital feedback.Results: From January 2020 to March 2021 (the third COVID-19 wave), the implementation rate of antibiotic administration within 3 hours after blood culture collection decreased as the COVID-19 pandemic spread, and the implementation rate tended to increase as the number of COVID-19-positive patients decreased. However, when the AST started monitoring and feedback from April 2021, although there was a temporary decline in the early stages of the fifth wave when the scale of infection was large, the implementation rate rose and was maintained by AST intervention. (the fourth and the fifth COVID-19 waves) (P< 0.01). Also, the implementation rate was significantly lower during the COVID-19 pandemic than during the non- pandemic (P< 0.05).Conclusion: The early COVID-19 pandemic may have affected the delay in time from blood culture collection to antibiotic administration. Later, in recurring COVID-19 pandemics, AST intervention eliminated this problem. When a bacterial infection such as sepsis is suspected, delayed treatment can be prevented by promptly collecting a blood culture, irrespective of concerns about COVID-19 infection. Calculating the QI may promote AST activities and the appropriate use of antibiotics.Keywords: coronavirus disease 2019, bacteremia, administration of antibiotics, quality indicator
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spelling doaj.art-670c782f502c411b924d828a48aabe882023-08-24T19:13:22ZengDove Medical PressInternational Journal of General Medicine1178-70742023-08-01Volume 163713371986153Impact of the COVID-19 Pandemic on Initiation of Antibiotic Treatment After Performing a Blood Culture and Intervention by the Antimicrobial Stewardship TeamKubota SSasano HSuzuki MFukui YChonan MKawakami TTabe YMiida TKimura TNaito TSanae Kubota,1 Hiroshi Sasano,2,3 Mai Suzuki,3 Yukiko Fukui,3 Masayoshi Chonan,4 Takaaki Kawakami,4 Yoko Tabe,5 Takashi Miida,5 Toshimi Kimura,1 Toshio Naito3 1Department of Pharmacy, Juntendo University Hospital, Tokyo, Japan; 2Department of Pharmacy, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan; 3Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan; 4Department of Clinical Laboratory, Juntendo University Hospital, Tokyo, Japan; 5Department of Clinical Laboratory Medicine, Juntendo University Faculty of Medicine, Tokyo, JapanCorrespondence: Hiroshi Sasano, Department of General Medicine, Juntendo University Faculty of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan, Tel +81 03-5802-1190, Email hsasano@juntendo.ac.jpPurpose: Whether the coronavirus disease 2019 (COVID-19) pandemic had any effect on the time between blood culture collection and administration of antibiotics in the outpatient Department of Emergency Medicine in a single university hospital in Japan was investigated, and the intervention carried out by the antimicrobial stewardship team (AST) to promote the appropriate use of antibiotics was examined.Patients and Methods: The monthly percentage of patients who visited the outpatient Department of Emergency Medicine between January 2019 and December 2021 and received an intravenous antibiotic within 3 hours of blood culture collection was calculated. The AST calculated a quality indicator (QI) based on the results of the investigation and started QI monitoring and hospital feedback.Results: From January 2020 to March 2021 (the third COVID-19 wave), the implementation rate of antibiotic administration within 3 hours after blood culture collection decreased as the COVID-19 pandemic spread, and the implementation rate tended to increase as the number of COVID-19-positive patients decreased. However, when the AST started monitoring and feedback from April 2021, although there was a temporary decline in the early stages of the fifth wave when the scale of infection was large, the implementation rate rose and was maintained by AST intervention. (the fourth and the fifth COVID-19 waves) (P< 0.01). Also, the implementation rate was significantly lower during the COVID-19 pandemic than during the non- pandemic (P< 0.05).Conclusion: The early COVID-19 pandemic may have affected the delay in time from blood culture collection to antibiotic administration. Later, in recurring COVID-19 pandemics, AST intervention eliminated this problem. When a bacterial infection such as sepsis is suspected, delayed treatment can be prevented by promptly collecting a blood culture, irrespective of concerns about COVID-19 infection. Calculating the QI may promote AST activities and the appropriate use of antibiotics.Keywords: coronavirus disease 2019, bacteremia, administration of antibiotics, quality indicatorhttps://www.dovepress.com/impact-of-the-covid-19-pandemic-on-initiation-of-antibiotic-treatment--peer-reviewed-fulltext-article-IJGMcoronavirus disease 2019bacteremiaadministration of antibioticsquality indicator
spellingShingle Kubota S
Sasano H
Suzuki M
Fukui Y
Chonan M
Kawakami T
Tabe Y
Miida T
Kimura T
Naito T
Impact of the COVID-19 Pandemic on Initiation of Antibiotic Treatment After Performing a Blood Culture and Intervention by the Antimicrobial Stewardship Team
International Journal of General Medicine
coronavirus disease 2019
bacteremia
administration of antibiotics
quality indicator
title Impact of the COVID-19 Pandemic on Initiation of Antibiotic Treatment After Performing a Blood Culture and Intervention by the Antimicrobial Stewardship Team
title_full Impact of the COVID-19 Pandemic on Initiation of Antibiotic Treatment After Performing a Blood Culture and Intervention by the Antimicrobial Stewardship Team
title_fullStr Impact of the COVID-19 Pandemic on Initiation of Antibiotic Treatment After Performing a Blood Culture and Intervention by the Antimicrobial Stewardship Team
title_full_unstemmed Impact of the COVID-19 Pandemic on Initiation of Antibiotic Treatment After Performing a Blood Culture and Intervention by the Antimicrobial Stewardship Team
title_short Impact of the COVID-19 Pandemic on Initiation of Antibiotic Treatment After Performing a Blood Culture and Intervention by the Antimicrobial Stewardship Team
title_sort impact of the covid 19 pandemic on initiation of antibiotic treatment after performing a blood culture and intervention by the antimicrobial stewardship team
topic coronavirus disease 2019
bacteremia
administration of antibiotics
quality indicator
url https://www.dovepress.com/impact-of-the-covid-19-pandemic-on-initiation-of-antibiotic-treatment--peer-reviewed-fulltext-article-IJGM
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