Surveillance of antibacterial usage during the COVID-19 pandemic in England, 2020

AMU COVID-19 Stakeholder Group, Amelia Andrews*, Emma Budd, Aoife Hendrick, Diane Ashiru Oredope, Elizabeth Beech, Susan Hopkins, Sarah Gerver, Berit Muller-Pebody

*Corresponding author for this work

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46 Citations (Scopus)
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Abstract

Changes in antibacterial prescribing during the COVID-19 pandemic were anticipated given that the clinical features of severe respiratory infection syndrome caused by SARS-CoV-2 mirror bacterial respiratory tract infections. Antibacterial consumption was measured in items/1000 population for primary care and in Defined Daily Doses (DDDs)/1000 admissions for secondary care in England from 2015 to October 2020. Interrupted time-series analyses were conducted to evaluate the effects of the pandemic on antibacterial consumption. In the community, the rate of antibacterial items prescribed decreased further in 2020 (by an extra 1.4% per month, 95% CI: −2.3 to −0.5) compared to before COVID-19. In hospitals, the volume of antibacterial use decreased during COVID-19 overall (−12.1% compared to pre-COVID, 95% CI: −19.1 to −4.4), although the rate of usage in hospitals increased steeply in April 2020. Use of antibacterials prescribed for respiratory infections and broad-spectrum antibacterials (predominately ‘Watch’ antibacterials in hospitals) increased in both settings. Overall volumes of antibacterial use at the beginning of the COVID-19 pandemic decreased in both primary and secondary settings, although there were increases in the rate of usage in hospitals in April 2020 and in specific antibacterials. This highlights the importance of antimicrobial stewardship during pandemics to ensure appropriate prescribing and avoid negative consequences on patient outcomes and antimicrobial resistance.

Original languageEnglish
Article number841
Number of pages13
JournalAntibiotics
Volume10
Issue number7
DOIs
Publication statusPublished - 10 Jul 2021

Bibliographical note

Funding Information: This research was carried out as enhanced surveillance of Public Health England’s routine work. S.H., A.A., S.G., and B.M.-P. are partly funded by the National Institute for Health Research (NIHR) Health Protection Research Unit (HPRU) in Healthcare-Associated Infections and Antimicrobial Resistance in a partnership between Public Health England (PHE) and (i) Imperial College London [NIHR200876] and (ii) the University of Oxford [NIHR200915].

Open Access: This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).

Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.

Citation: Andrews, A.; Budd, E.L.; Hendrick, A.; Ashiru-Oredope, D.; Beech, E.; Hopkins, S.; Gerver, S.; Muller-Pebody, B.; the AMU COVID-19 Stakeholder Group. Surveillance of Antibacterial Usage during the COVID-19 Pandemic in England, 2020. Antibiotics 2021, 10, 841. https://doi.org/10.3390/antibiotics10070841

DOI: https://doi.org/10.3390/antibiotics10070841

Keywords

  • Antibacterials
  • Antibiotics
  • Antimicrobial stewardship
  • COVID-19

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