The impact of the COVID-19 pandemic on antimicrobial usage : an international patient-level cohort study

Article Article scientifique Article The impact of the COVID-19 pandemic on antimicrobial usage : an international patient-level cohort study eng 2025-03-26 2025-04 author Farzana Refath Department of Biology, Ineos Oxford Institute for Antimicrobial Research, University of Oxford, Oxford, UK. author Harbarth Stéphan Juergen 0000-0002-3551-1025 Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland.,WHO Collaborating Center for Antimicrobial Resistance and Infection Control, Geneva, Switzerland. 93885 Département de médecine (DEMED) author Yu Ly-Mee 0000-0003-0331-7364 Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK. author Carretto Edoardo 0000-0001-6521-5887 Clinical Microbiology Laboratory, IRCCS Azienda Unità Sanitaria Locale, Reggio Emilia, Italy. author Moore Catrin E Institute for Infection and Immunity, St George's, University of London, London, UK. author Feasey Nicholas Alexander 0000-0003-4041-1405 School of Medicine, University of St Andrews, St Andrews, Fife, UK.,Malawi Liverpool Wellcome Programme, Kamuzu University of Health Sciences, Blantyre, Malawi. author Gales Ana C Division of Infectious Diseases, Universidade Federal de São Paulo, São Paulo, Brazil.,Antimicrobial Resistance Institute of São Paulo (ARIES), São Paulo, Brazil. author Galal Ushma Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK. author Ergonul Onder Koc University İşbank Center for Infectious Diseases, Koc University, Istanbul, Türkiye.,School of Medicine, Koç University, Istanbul, Türkiye. author Yong Dongeun Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, South Korea. author Yusuf Md Abdullah Department of Microbiology, National Institute of Neurosciences and Hospital, Dhaka, Bangladesh. author Veeraraghavan Balaji Department of Clinical Microbiology, Christian Medical College, Vellore, India. author Iregbu Kenneth Chukwuemeka Department of Microbiology, University of Abuja, Abuja, Nigeria.,Department of Microbiology, National Hospital Abuja, Abuja, Nigeria. author van Santen James Anton Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK. author Ribeiro Aghata Cardoso da Silva Division of Infectious Diseases, Universidade Federal de São Paulo, São Paulo, Brazil.,Antimicrobial Resistance Institute of São Paulo (ARIES), São Paulo, Brazil. author Fankhauser-Rodriguez Carolina Maria Infection and Prevention Control, Geneva University Hospitals, Geneva, Switzerland. 37177 author Chilupsya Chisomo Judith Malawi Liverpool Wellcome Programme, Kamuzu University of Health Sciences, Blantyre, Malawi. author Dolecek Christiane Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK. author Ferreira Diogo Boldim Division of Infectious Diseases, Universidade Federal de São Paulo, São Paulo, Brazil. author Pinarlik Fatihan Koc University İşbank Center for Infectious Diseases, Koc University, Istanbul, Türkiye.,Graduate School of Health Sciences, Koc University, Istanbul, Türkiye. author Jang Jaehyeok Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, South Korea. author Gücer Lal Sude Koc University İşbank Center for Infectious Diseases, Koc University, Istanbul, Türkiye.,School of Medicine, Koç University, Istanbul, Türkiye. author Cavazzuti Laura Hospital Hygiene Unit, IRCCS Azienda Unità Sanitaria Locale, Reggio Emilia, Italy. author Sultana Marufa Department of Microbiology, National Institute of Neurosciences and Hospital, Dhaka, Bangladesh.,Administration, Dhaka Medical College Hospital, Dhaka, Bangladesh. author Haque M D Nazmul Administration, Dhaka Medical College Hospital, Dhaka, Bangladesh.,Combined Military Hospital, Jashore Cantonment, Jashore, Bangladesh. author Galas Murielle Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland. 404160 author Medugu Nubwa Department of Microbiology, National Hospital Abuja, Abuja, Nigeria.,Department of Microbiology, Nile University of Nigeria, Abuja, Nigeria. author Nwajiobi-Princewill Philip Ifeanyi Department of Microbiology, National Hospital Abuja, Abuja, Nigeria. author Marrollo Roberta Clinical Microbiology Laboratory, IRCCS Azienda Unità Sanitaria Locale, Reggio Emilia, Italy. author Zhao Rui Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK. author Baskaran Vivekanandan B Department of Clinical Microbiology, Christian Medical College, Vellore, India. author Peter J V Medical Intensive Care Unit, Christian Medical College, Vellore, India. author Chandy Sujith J Department of Pharmacology & Clinical Pharmacology, Christian Medical College, Vellore, India. author Bakthavatchalam Yamuna Devi Department of Clinical Microbiology, Christian Medical College, Vellore, India. author Walsh Timothy R Department of Biology, Ineos Oxford Institute for Antimicrobial Research, University of Oxford, Oxford, UK. COVID-19/DRI Study Group collaborator Cherkaoui Abdessalam 504646 Département de médecine (DEMED) collaborator Colaizzi Nadia 110422 collaborator Fonton Perince 402483 Département de médecine (DEMED) collaborator Stucki Cyril 503020 dlaf037 10.1093/jacamr/dlaf037 40151230 2632-1823 PMC11945301 https://academic.oup.com/jacamr/article/7/2/dlaf037/8096369 Background: This study aimed to evaluate the trends in antimicrobial prescription during the first 1.5 years of COVID-19 pandemic. Methods: This was an observational, retrospective cohort study using patient-level data from Bangladesh, Brazil, India, Italy, Malawi, Nigeria, South Korea, Switzerland and Turkey from patients with pneumonia and/or acute respiratory distress syndrome and/or sepsis, regardless of COVID-19 positivity, who were admitted to critical care units or COVID-19 specialized wards. The changes of antimicrobial prescription between pre-pandemic and pandemic were estimated using logistic or linear regression. Pandemic effects on month-wise antimicrobial usage were evaluated using interrupted time series analyses (ITSAs). Results: Antimicrobials for which prescriptions significantly increased during the pandemic were as follows: meropenem in Bangladesh (95% CI: 1.94-4.07) with increased prescribed daily dose (PDD) (95% CI: 1.17-1.58) and Turkey (95% CI: 1.09-1.58), moxifloxacin in Bangladesh (95% CI: 4.11-11.87) with increased days of therapy (DOT) (95% CI: 1.14-2.56), piperacillin/tazobactam in Italy (95% CI: 1.07-1.48) with increased DOT (95% CI: 1.01-1.25) and PDD (95% CI: 1.05-1.21) and azithromycin in Bangladesh (95% CI: 3.36-21.77) and Brazil (95% CI: 2.33-8.42). ITSA showed a significant drop in azithromycin usage in India (95% CI: -8.38 to -3.49 g/100 patients) and South Korea (95% CI: -2.83 to -1.89 g/100 patients) after WHO guidelines v1 release and increased meropenem usage (95% CI: 93.40-126.48 g/100 patients) and moxifloxacin (95% CI: 5.40-13.98 g/100 patients) in Bangladesh and sulfamethoxazole/trimethoprim in India (95% CI: 0.92-9.32 g/100 patients) following the Delta variant emergence. Conclusions: This study reinforces the importance of developing antimicrobial stewardship in the clinical settings during inter-pandemic periods. Dewey 616 56 Département de médecine 221 false 526 Résistance aux antibiotiques 866 JAC-antimicrobial resistance 7 2 88ef047d-4c39-4f0a-a1ec-19ec88c468be Article (Published version) Public Article_scientifique_from_europePmc.pdf 1794650 application/pdf CC BY-4.0 4fb05f677ed0ff554d8df77150542fbe3aab5f7d3f3833525bf5c0796603dcf2 1e69b052-4276-4c70-bd1c-ebffbab9d83a Appendix Public dlaf037_supplementary_data.docx 4603744 application/vnd.openxmlformats-officedocument.wordprocessingml.document d1094ec27fec51a0b9937137c0f4217f255e0c608b15e3d287cb8d6fe4d04f4d openAccess Faculté de médecine / Section de médecine clinique / Département de médecine

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The impact of the COVID-19 pandemic on antimicrobial usage : an international patient-level cohort study	JAC-antimicrobial resistance			2025	63	48

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