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Salehi M, Khalili H, Seifi A, Davoudi H, Darazam IA, Jahangard‐Rafsanjani Z, Mohammadnejad E, Heydari B, Siahkaly SJM, Tabarsi P, Kalantari S, Menshadi SAD, Babamahmoodi F, Khorvash F, Davarpanah MA, Soltani R, Yaghoobi MH, Anari SAM, Khodadadi J, Aliramezani A, Hantooshzadeh S, Naderi HR, Hajiabdolbaghi M, Elyasi S, Firouzabadi D, Kasgari HA, Roshanzamiri S, Ebrahimpour S. Antibiotic use during the first 6 months of COVID-19 pandemic in Iran: A large-scale multi-centre study. J Clin Pharm Ther 2022; 47:2140-2151. [PMID: 36054303 PMCID: PMC9538430 DOI: 10.1111/jcpt.13761] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 07/21/2022] [Accepted: 08/02/2022] [Indexed: 12/24/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Although antibiotics are ineffective against viral infections, epidemiological studies have revealed that the COVID-19 pandemic resulted in the overuse of antibiotics and disruption of antimicrobial stewardship programmes. We investigated the pattern of antibiotic use during the first 6 months of the COVID-19 pandemic in Iran. METHODS A multi-centre retrospective study was designed to investigate the use of 16 broad-spectrum antibiotics in 12 medical centres. The rate of antibiotic use was calculated and reported based on the Defined Daily Dose (DDD) per 100 hospital bed-days. The bacterial co-infection rate was also reported. RESULTS AND DISCUSSION Totally, 43,791 hospitalized COVID-19 patients were recruited in this study. It was found that 121.6 DDD of antibiotics were used per 100 hospital bed-days, which estimated that each patient received approximately 1.21 DDDs of antibiotics every day. However, the bacterial co-infections were detected only in 14.4% of the cases. A direct correlation was observed between the rate of antibiotic use and mortality (r[142] = 0.237, p = 0.004). The rate of antibiotic consumption was not significantly different between the ICU and non-ICU settings (p = 0.15). WHAT IS NEW AND CONCLUSION In this study, widespread antibiotic use was detected in the absence of the confirmed bacterial coinfection in COVID-19 patients. This over-consumption of broad-spectrum antibiotics may be associated with increased mortality in hospitalized COVID-19 patients, which can be an alarming finding.
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Affiliation(s)
- Mohammadreza Salehi
- Infectious Diseases Department, Imam Khomeini Hospital ComplexTehran University of Medical SciencesTehranIran
| | - Hossein Khalili
- Department of Clinical Pharmacy, School of PharmacyTehran University of Medical SciencesTehranIran
| | - Arash Seifi
- Infectious Diseases Department, Imam Khomeini Hospital ComplexTehran University of Medical SciencesTehranIran
| | - Hamidreza Davoudi
- Department of Pharmaceutical Care, Imam Khomeini Hospital ComplexTehran University of Medical SciencesTehranIran
| | - Ilad Alavi Darazam
- Department of Infectious Disease, Loghman Hakim HospitalShahid Beheshti University of Medical SciencesTehranIran
| | | | - Esmaeil Mohammadnejad
- Department of Medical‐Surgical Nursing and Basic Sciences, Imam Khomeini Hospital ComplexTehran University of Medical SciencesTehranIran
| | - Behrooz Heydari
- Department of Clinical Pharmacy, School of PharmacyShahid Sadoughi University of Medical SciencesYazdIran
| | | | - Payam Tabarsi
- Department of Infectious Disease, School of Medicine, National Research Institute of Tuberculosis and Lung Diseases, Dr. Masih Daneshvari HospitalShahid Beheshti University of Medical SciencesTehranIran
| | - Saeed Kalantari
- Department of Infectious Disease, School of Medicine, Hazrat‐e Rasool General HospitalIran University of Medical SciencesTehranIran
| | - Seyed Ali Dehghan Menshadi
- Infectious Diseases Department, Imam Khomeini Hospital ComplexTehran University of Medical SciencesTehranIran
| | - Farhang Babamahmoodi
- Department of Infectious Diseases, Antimicrobial Resistance Research Center, Communicable Diseases Institute, Ghaem Shahr Razi HospitalMazandaran University of Medical SciencesSariMazandaranIran
| | - Farzin Khorvash
- Department of Infectious Diseases and Tropical Medicine, Nosocomial Infection Research Center, Al‐Zahra HospitalIsfahan University of Medical SciencesIsfahanIran
| | - Mohammad Ali Davarpanah
- Department of Internal Medicine, HIV/AIDS Research Center, Research Institute for Health, Namazi Teaching HospitalShiraz University of Medical SciencesShirazIran
| | - Rasool Soltani
- Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical SciencesIsfahan University of Medical SciencesIsfahanIran
| | - Mojtaba Hedayat Yaghoobi
- Department of Infectious Diseases, School of MedicineAlborz University of Medical SciencesKarajAlborzIran
| | - Seyed Alireza Mosavi Anari
- Department of Infectious Disease, Infectious Diseases Research Center, Shahid Sadoughi General HospitalShahid Sadoughi University of Medical SciencesYazdIran
| | - Javad Khodadadi
- Department of Infectious Disease, Kamkar‐Arabnia HospitalQom University of Medical SciencesQomIran
| | - Amir Aliramezani
- Department of Microbiology, Shohadaye Tajrish HospitalShahid Beheshti University of Medical SciencesTehranIran
| | - Sedigheh Hantooshzadeh
- Department of Obstetrics and Gynecology, School of Medicine, Family Health Research Institute, Imam Khomeini HospitalTehran University of Medical SciencesTehranIran
| | - Hamid Reza Naderi
- Department of Infectious Disease, Surgical Oncology Research Center, Imam Reza HospitalMashhad University of Medical SciencesMashhadIran
| | - Mahboobeh Hajiabdolbaghi
- Infectious Diseases Department, Imam Khomeini Hospital ComplexTehran University of Medical SciencesTehranIran
| | - Sepideh Elyasi
- Department of Clinical Pharmacy, School of PharmacyMashhad University of Medical SciencesMashhadIran
| | - Dena Firouzabadi
- Department of Clinical Pharmacy, School of PharmacyShiraz University of Medical SciencesShirazIran
| | - Hamideh Abbaspour Kasgari
- Department of Clinical Pharmacy, School of PharmacyMazandaran University of Medical SciencesSariIran
| | - Soheil Roshanzamiri
- Department of Clinical Pharmacy, School of PharmacyShahid Beheshti University of Medical SciencesTehranIran
| | - Sholeh Ebrahimpour
- Department of Clinical Pharmacy, School of PharmacyAlborz University of Medical SciencesAlborzIran
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