Evolution of Antimicrobial Consumption During the First Wave of COVID-19 Pandemic

• Main Authors: Santiago Grau (Author), Daniel Echeverria-Esnal (Author), Silvia Gómez-Zorrilla (Author), Maria Eugenia Navarrete-Rouco (Author), Joan Ramon Masclans (Author), Merce Espona (Author), Maria Pilar Gracia-Arnillas (Author), Xavier Duran (Author), Merce Comas (Author), Juan Pablo Horcajada (Author), Olivia Ferrández (Author)
• Format: Book
• Published: MDPI AG, 2021-01-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 10.3390/antibiotics10020132; 2079-6382
• Keywords: antimicrobial stewardship; COVID-19; defined daily doses (DDD); antimicrobial resistance; antibiotic consumption; Therapeutics. Pharmacology; RM1-950
• Source: Antibiotics, Vol 10, Iss 2, p 132 (2021)

<i>Background:</i> The first wave of COVID-19 pandemic may have significantly impacted antimicrobial consumption in hospitals. The objective of this study was to assess the evolution of antimicrobial consumption during this period. <i>Methods</i>: A retrospective quasi-experimental before-after study was conducted in a Spanish tertiary care hospital. The study compared two periods: pre-pandemic, from January 2018 to February 2020, and during the COVID-19 pandemic from March to June 2020. Antimicrobial consumption was analyzed monthly as defined daily doses (DDD)/100 bed-days and overall hospital and ICU consumption were evaluated. <i>Results:</i> An increase in the hospital consumption was noticed. Although only ceftaroline achieved statistical significance (<i>p</i> = 0.014), a rise was observed in most of the studied antimicrobials. A clear temporal pattern was detected. While an increase in ceftriaxone and azithromycin was observed during March, an increment in the consumption of daptomycin, carbapenems, linezolid, ceftaroline, novel cephalosporin/β-lactamase inhibitors or triazoles during April-May was noticed. In the ICU, these findings were more evident, namely ceftriaxone (<i>p</i> = 0.029), carbapenems (<i>p</i> = 0.002), daptomycin (<i>p</i> = 0.002), azithromycin (<i>p</i> = 0.030), and linezolid (<i>p</i> = 0.011) but followed a similar temporal pattern. <i>Conclusion</i>: An increase in the antimicrobial consumption during the first wave of COVID-19 pandemic was noticed, especially in the ICU. Availability of updated protocols and antimicrobial stewardship programs are essential to optimize these outcomes.