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Zaha DC, Ilea CDN, Dorobanțu FR, Pantiș C, Pop ON, Dascal DG, Dorobanțu CD, Manole F. The Impact of SARS-CoV-2 Pandemic on Antibiotic Prescriptions and Resistance in a University Hospital from Romania. Antibiotics (Basel) 2024; 13:477. [PMID: 38927144 PMCID: PMC11200525 DOI: 10.3390/antibiotics13060477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 05/20/2024] [Accepted: 05/21/2024] [Indexed: 06/28/2024] Open
Abstract
This paper aimed to evaluate the effects of the COVID-19 pandemic on prescription rates and antibiotic resistance in a university hospital. A retrospective study was conducted on the medical records of patients admitted to the Bihor Emergency Clinical County Hospital in Romania in 2019 (pre-pandemic) and 2021 (during the pandemic period). We evaluated the antibiotic consumption index (ACI) and susceptibility rates. The overall percentage of antibiotic prescribing increased in 2021, while the total number of patients decreased. Genito-urinary, digestive, respiratory infections, heart diseases and wounds were the most common conditions for antibiotic prescriptions, but the number of them decreased in 2021. There was a decrease in the proportion of antibiotics from the Watch and Reserve class and an increase in the proportion of antibiotics from the Access class. Antibiotic use has been reduced despite an increase in the number of patients, with a high consumption in the Watch group in the ICU wards. By contrast, surgical wards had the highest rate of antibiotic prescriptions, but a decrease in the number of patients. The patients who were administered antibiotics were hospitalized for diagnoses other than COVID-19. Almost all prescribed antibiotics displayed decreasing sensitivity rates. The number of isolated ESKAPE pathogens, except for Staphylococcus aureus methicillin-resistant strains, were increased. Strategies to control antibiotic prescriptions and the spread of resistant pathogens should be improved.
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Affiliation(s)
- Dana Carmen Zaha
- Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 1st University Street, 410087 Oradea, Romania; (D.C.Z.); (D.G.D.)
| | - Codrin Dan Nicolae Ilea
- Bihor Emergency Clinical County Hospital, 410087 Oradea, Romania
- Department of Biostatistics, Faculty of Medicine and Pharmacy, University of Oradea, 1st University Street, 410087 Oradea, Romania
| | - Florica Ramona Dorobanțu
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 1st University Street, 410087 Oradea, Romania;
| | - Carmen Pantiș
- Department of Surgical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 1st University Street, 410087 Oradea, Romania; (C.P.); (C.D.D.); (F.M.)
| | - Ovidiu Nicolae Pop
- Department of Surgical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 1st University Street, 410087 Oradea, Romania; (C.P.); (C.D.D.); (F.M.)
| | - Dorina Gabriela Dascal
- Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 1st University Street, 410087 Oradea, Romania; (D.C.Z.); (D.G.D.)
| | - Cătălin Dorin Dorobanțu
- Department of Surgical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 1st University Street, 410087 Oradea, Romania; (C.P.); (C.D.D.); (F.M.)
| | - Felicia Manole
- Department of Surgical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 1st University Street, 410087 Oradea, Romania; (C.P.); (C.D.D.); (F.M.)
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Durà-Miralles X, Abelenda-Alonso G, Bergas A, Laporte-Amargós J, Sastre-Escolà E, Padullés A, Carratalà J, Gudiol C. An Ocean between the Waves: Trends in Antimicrobial Consumption in Hospitalized Patients with COVID-19. Antibiotics (Basel) 2024; 13:55. [PMID: 38247614 PMCID: PMC10812529 DOI: 10.3390/antibiotics13010055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 12/29/2023] [Accepted: 01/03/2024] [Indexed: 01/23/2024] Open
Abstract
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 SpO2/FiO2 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.
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Affiliation(s)
- Xavier Durà-Miralles
- Department of Infectious Diseases, Bellvitge University Hospital, Hospitalet de Llobregat, 08907 Barcelona, Spain; (X.D.-M.); (A.B.); (E.S.-E.)
- Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Gabriela Abelenda-Alonso
- Department of Infectious Diseases, Bellvitge University Hospital, Hospitalet de Llobregat, 08907 Barcelona, Spain; (X.D.-M.); (A.B.); (E.S.-E.)
- Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet de Llobregat, 08907 Barcelona, Spain
- Center for Biomedical Research in Infectious Diseases Network (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain;
| | - Alba Bergas
- Department of Infectious Diseases, Bellvitge University Hospital, Hospitalet de Llobregat, 08907 Barcelona, Spain; (X.D.-M.); (A.B.); (E.S.-E.)
- Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Júlia Laporte-Amargós
- Department of Infectious Diseases, Bellvitge University Hospital, Hospitalet de Llobregat, 08907 Barcelona, Spain; (X.D.-M.); (A.B.); (E.S.-E.)
- Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Enric Sastre-Escolà
- Department of Infectious Diseases, Bellvitge University Hospital, Hospitalet de Llobregat, 08907 Barcelona, Spain; (X.D.-M.); (A.B.); (E.S.-E.)
- Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet de Llobregat, 08907 Barcelona, Spain
- Center for Biomedical Research in Infectious Diseases Network (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain;
| | - Ariadna Padullés
- Center for Biomedical Research in Infectious Diseases Network (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain;
- Department of Pharmacy, Bellvitge University Hospital, Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Jordi Carratalà
- Department of Infectious Diseases, Bellvitge University Hospital, Hospitalet de Llobregat, 08907 Barcelona, Spain; (X.D.-M.); (A.B.); (E.S.-E.)
- Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet de Llobregat, 08907 Barcelona, Spain
- Center for Biomedical Research in Infectious Diseases Network (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain;
- Facultat de Medicina i Ciències de la Salut, University of Barcelona, Campus Bellvitge, Hospitalet de Llobregat, 08907 Barcelona, Spain
| | - Carlota Gudiol
- Department of Infectious Diseases, Bellvitge University Hospital, Hospitalet de Llobregat, 08907 Barcelona, Spain; (X.D.-M.); (A.B.); (E.S.-E.)
- Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet de Llobregat, 08907 Barcelona, Spain
- Center for Biomedical Research in Infectious Diseases Network (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain;
- Facultat de Medicina i Ciències de la Salut, University of Barcelona, Campus Bellvitge, Hospitalet de Llobregat, 08907 Barcelona, Spain
- Institut Català d’Oncologia (ICO), Hospital Duran i Reynals, IDIBELL, Hospitalet de Llobregat, 08908 Barcelona, Spain
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