An Ocean between the Waves: Trends in Antimicrobial Consumption in Hospitalized Patients with COVID-19
We assessed the antibiotic use in SARS-CoV-2-infected patients during four different waves of the COVID-19 pandemic, as well as its trends over the period and associated risk factors. We performed a cross-sectional retrospective analysis nested in a prospectively collected cohort of hospitalized adu...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-01-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/13/1/55 |
| _version_ | 1797344782516748288 |
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| author | Xavier Durà-Miralles Gabriela Abelenda-Alonso Alba Bergas Júlia Laporte-Amargós Enric Sastre-Escolà Ariadna Padullés Jordi Carratalà Carlota Gudiol |
| author_facet | Xavier Durà-Miralles Gabriela Abelenda-Alonso Alba Bergas Júlia Laporte-Amargós Enric Sastre-Escolà Ariadna Padullés Jordi Carratalà Carlota Gudiol |
| author_sort | Xavier Durà-Miralles |
| collection | DOAJ |
| description | We assessed the antibiotic use in SARS-CoV-2-infected patients during four different waves of the COVID-19 pandemic, as well as its trends over the period and associated risk factors. We performed a cross-sectional retrospective analysis nested in a prospectively collected cohort of hospitalized adult patients with COVID-19 at a university hospital in Spain. A total of 2415 patients were included in this study, among whom 1120 corresponded to the first wave. The highest percentage of patients receiving some sort of antibiotic treatment was higher during the first wave (77.6%) than during the others; nevertheless, our calculation of the average DOT (days of antibiotic treatment) per 100 patient days of stay found that the highest antibiotic prescription rate corresponded to the second pandemic wave (61.61 DOT/100 patient days), which was associated with a higher ICU admission rate and a lower SpO<sub>2</sub>/FiO<sub>2</sub> ratio at admission. After the second wave, the prescription rates presented a steady downward trend. With regard to the use of specific antibiotic families, amoxicillin/clavulanate was the most used antibiotic in our cohort (14.20 DOT/100 patient days) due to a high prescription rate during the first wave. According to the “AWaRe” WHO classification, antibiotics corresponding to the “Watch” group were the most prescribed (27.92 DOT/100 patient days). The antibiotic use rate fell progressively, but it remained high during all four waves analyzed. In conclusion, antibiotic use was high throughout all the waves that were analyzed, despite a relatively low incidence of bacterial coinfection and superinfection. Efforts should be made to keep antimicrobial stewardship programs active, especially in complicated epidemiological situations, such as the SARS-CoV-2 pandemic. |
| first_indexed | 2024-03-08T11:07:54Z |
| format | Article |
| id | doaj.art-e26b1fae564e470fb1f78c3570ae72bd |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-08T11:07:54Z |
| publishDate | 2024-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-e26b1fae564e470fb1f78c3570ae72bd2024-01-26T14:37:12ZengMDPI AGAntibiotics2079-63822024-01-011315510.3390/antibiotics13010055An Ocean between the Waves: Trends in Antimicrobial Consumption in Hospitalized Patients with COVID-19Xavier Durà-Miralles0Gabriela Abelenda-Alonso1Alba Bergas2Júlia Laporte-Amargós3Enric Sastre-Escolà4Ariadna Padullés5Jordi Carratalà6Carlota Gudiol7Department of Infectious Diseases, Bellvitge University Hospital, Hospitalet de Llobregat, 08907 Barcelona, SpainDepartment of Infectious Diseases, Bellvitge University Hospital, Hospitalet de Llobregat, 08907 Barcelona, SpainDepartment of Infectious Diseases, Bellvitge University Hospital, Hospitalet de Llobregat, 08907 Barcelona, SpainDepartment of Infectious Diseases, Bellvitge University Hospital, Hospitalet de Llobregat, 08907 Barcelona, SpainDepartment of Infectious Diseases, Bellvitge University Hospital, Hospitalet de Llobregat, 08907 Barcelona, SpainCenter for Biomedical Research in Infectious Diseases Network (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, SpainDepartment of Infectious Diseases, Bellvitge University Hospital, Hospitalet de Llobregat, 08907 Barcelona, SpainDepartment of Infectious Diseases, Bellvitge University Hospital, Hospitalet de Llobregat, 08907 Barcelona, SpainWe assessed the antibiotic use in SARS-CoV-2-infected patients during four different waves of the COVID-19 pandemic, as well as its trends over the period and associated risk factors. We performed a cross-sectional retrospective analysis nested in a prospectively collected cohort of hospitalized adult patients with COVID-19 at a university hospital in Spain. A total of 2415 patients were included in this study, among whom 1120 corresponded to the first wave. The highest percentage of patients receiving some sort of antibiotic treatment was higher during the first wave (77.6%) than during the others; nevertheless, our calculation of the average DOT (days of antibiotic treatment) per 100 patient days of stay found that the highest antibiotic prescription rate corresponded to the second pandemic wave (61.61 DOT/100 patient days), which was associated with a higher ICU admission rate and a lower SpO<sub>2</sub>/FiO<sub>2</sub> ratio at admission. After the second wave, the prescription rates presented a steady downward trend. With regard to the use of specific antibiotic families, amoxicillin/clavulanate was the most used antibiotic in our cohort (14.20 DOT/100 patient days) due to a high prescription rate during the first wave. According to the “AWaRe” WHO classification, antibiotics corresponding to the “Watch” group were the most prescribed (27.92 DOT/100 patient days). The antibiotic use rate fell progressively, but it remained high during all four waves analyzed. In conclusion, antibiotic use was high throughout all the waves that were analyzed, despite a relatively low incidence of bacterial coinfection and superinfection. Efforts should be made to keep antimicrobial stewardship programs active, especially in complicated epidemiological situations, such as the SARS-CoV-2 pandemic.https://www.mdpi.com/2079-6382/13/1/55COVID-19antibioticpandemicstewardship |
| spellingShingle | Xavier Durà-Miralles Gabriela Abelenda-Alonso Alba Bergas Júlia Laporte-Amargós Enric Sastre-Escolà Ariadna Padullés Jordi Carratalà Carlota Gudiol An Ocean between the Waves: Trends in Antimicrobial Consumption in Hospitalized Patients with COVID-19 Antibiotics COVID-19 antibiotic pandemic stewardship |
| title | An Ocean between the Waves: Trends in Antimicrobial Consumption in Hospitalized Patients with COVID-19 |
| title_full | An Ocean between the Waves: Trends in Antimicrobial Consumption in Hospitalized Patients with COVID-19 |
| title_fullStr | An Ocean between the Waves: Trends in Antimicrobial Consumption in Hospitalized Patients with COVID-19 |
| title_full_unstemmed | An Ocean between the Waves: Trends in Antimicrobial Consumption in Hospitalized Patients with COVID-19 |
| title_short | An Ocean between the Waves: Trends in Antimicrobial Consumption in Hospitalized Patients with COVID-19 |
| title_sort | ocean between the waves trends in antimicrobial consumption in hospitalized patients with covid 19 |
| topic | COVID-19 antibiotic pandemic stewardship |
| url | https://www.mdpi.com/2079-6382/13/1/55 |
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