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Hospital antibiotic consumption—an interrupted time series analysis of the early and late phases of the COVID-19 pandemic in Poland, a retrospective study
BACKGROUND: COVID-19 has been challenging for the entire healthcare system, due to the lack of sufficient treatment protocols, especially during initial phases and as regards antibiotic use. The aim of this study was to identify the trends of antimicrobial consumption in one of the largest tertiary...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10073786/ https://www.ncbi.nlm.nih.gov/pubmed/37017868 http://dx.doi.org/10.1007/s43440-023-00479-z |
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author | Siewierska, Małgorzata Gajda, Mateusz Opalska, Aleksandra Brudło, Michał Krzyściak, Paweł Gryglewska, Barbara Różańska, Anna Wójkowska-Mach, Jadwiga |
author_facet | Siewierska, Małgorzata Gajda, Mateusz Opalska, Aleksandra Brudło, Michał Krzyściak, Paweł Gryglewska, Barbara Różańska, Anna Wójkowska-Mach, Jadwiga |
author_sort | Siewierska, Małgorzata |
collection | PubMed |
description | BACKGROUND: COVID-19 has been challenging for the entire healthcare system, due to the lack of sufficient treatment protocols, especially during initial phases and as regards antibiotic use. The aim of this study was to identify the trends of antimicrobial consumption in one of the largest tertiary hospitals in Poland during COVID-19. METHODS: This is a retrospective study conducted at the University Hospital in Krakow, Poland, between Feb/Mar 2020 and Feb 2021. It included 250 patients. All included patients were hospitalized due to COVID-19 with confirmed SARS-CoV-2 infection without bacterial co-infections during the first phase of COVID-19 in Europe and following 3-month intervals: five equal groups of patients in each. COVID severity and antibiotic consumption were assessed according to WHO recommendations. RESULTS: In total 178 (71.2%) patients received antibiotics with a incidence rate of laboratory-confirmed healthcare-associated infection (LC-HAI) was 20%. The severity of COVID-19 was mild in 40.8%, moderate in 36.8%, and severe in 22.4% cases. The ABX administration was significantly higher for intensive care unit (ICU) patients (97.7% vs. 65.7%). Length of hospital stay was extended for patients with ABX (22.3 vs. 14.4 days). In total, 3 946.87 DDDs of ABXs were used, including 1512.63 DDDs in ICU, accounting for 780.94 and 2522.73 per 1000 hospital days, respectively. The median values of antibiotic DDD were greater among patients with severe COVID-19 than others (20.92). Patients admitted at the beginning of the pandemic (Feb/Mar, May 2020) had significantly greater values of median DDDs, respectively, 25.3 and 16.0 compared to those admitted in later (Aug, Nov 2020; Feb 2021), respectively, 11.0, 11.0 and 11.2, but the proportion of patients receiving ABX therapy was lower in Feb/Mar and May 2020 (62.0 and 48.0%), whereas the highest during the late period of the pandemic, i.e., in Aug, Nov. 2020 and Feb. 2021 (78% and both 84.0%). CONCLUSIONS: Data suggest great misuse of antibiotics without relevant data about HAIs. Almost all ICU patients received some antibiotics, which was correlated with prolonged hospitalization. |
format | Online Article Text |
id | pubmed-10073786 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-100737862023-04-05 Hospital antibiotic consumption—an interrupted time series analysis of the early and late phases of the COVID-19 pandemic in Poland, a retrospective study Siewierska, Małgorzata Gajda, Mateusz Opalska, Aleksandra Brudło, Michał Krzyściak, Paweł Gryglewska, Barbara Różańska, Anna Wójkowska-Mach, Jadwiga Pharmacol Rep Article BACKGROUND: COVID-19 has been challenging for the entire healthcare system, due to the lack of sufficient treatment protocols, especially during initial phases and as regards antibiotic use. The aim of this study was to identify the trends of antimicrobial consumption in one of the largest tertiary hospitals in Poland during COVID-19. METHODS: This is a retrospective study conducted at the University Hospital in Krakow, Poland, between Feb/Mar 2020 and Feb 2021. It included 250 patients. All included patients were hospitalized due to COVID-19 with confirmed SARS-CoV-2 infection without bacterial co-infections during the first phase of COVID-19 in Europe and following 3-month intervals: five equal groups of patients in each. COVID severity and antibiotic consumption were assessed according to WHO recommendations. RESULTS: In total 178 (71.2%) patients received antibiotics with a incidence rate of laboratory-confirmed healthcare-associated infection (LC-HAI) was 20%. The severity of COVID-19 was mild in 40.8%, moderate in 36.8%, and severe in 22.4% cases. The ABX administration was significantly higher for intensive care unit (ICU) patients (97.7% vs. 65.7%). Length of hospital stay was extended for patients with ABX (22.3 vs. 14.4 days). In total, 3 946.87 DDDs of ABXs were used, including 1512.63 DDDs in ICU, accounting for 780.94 and 2522.73 per 1000 hospital days, respectively. The median values of antibiotic DDD were greater among patients with severe COVID-19 than others (20.92). Patients admitted at the beginning of the pandemic (Feb/Mar, May 2020) had significantly greater values of median DDDs, respectively, 25.3 and 16.0 compared to those admitted in later (Aug, Nov 2020; Feb 2021), respectively, 11.0, 11.0 and 11.2, but the proportion of patients receiving ABX therapy was lower in Feb/Mar and May 2020 (62.0 and 48.0%), whereas the highest during the late period of the pandemic, i.e., in Aug, Nov. 2020 and Feb. 2021 (78% and both 84.0%). CONCLUSIONS: Data suggest great misuse of antibiotics without relevant data about HAIs. Almost all ICU patients received some antibiotics, which was correlated with prolonged hospitalization. Springer International Publishing 2023-04-05 2023 /pmc/articles/PMC10073786/ /pubmed/37017868 http://dx.doi.org/10.1007/s43440-023-00479-z Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Article Siewierska, Małgorzata Gajda, Mateusz Opalska, Aleksandra Brudło, Michał Krzyściak, Paweł Gryglewska, Barbara Różańska, Anna Wójkowska-Mach, Jadwiga Hospital antibiotic consumption—an interrupted time series analysis of the early and late phases of the COVID-19 pandemic in Poland, a retrospective study |
title | Hospital antibiotic consumption—an interrupted time series analysis of the early and late phases of the COVID-19 pandemic in Poland, a retrospective study |
title_full | Hospital antibiotic consumption—an interrupted time series analysis of the early and late phases of the COVID-19 pandemic in Poland, a retrospective study |
title_fullStr | Hospital antibiotic consumption—an interrupted time series analysis of the early and late phases of the COVID-19 pandemic in Poland, a retrospective study |
title_full_unstemmed | Hospital antibiotic consumption—an interrupted time series analysis of the early and late phases of the COVID-19 pandemic in Poland, a retrospective study |
title_short | Hospital antibiotic consumption—an interrupted time series analysis of the early and late phases of the COVID-19 pandemic in Poland, a retrospective study |
title_sort | hospital antibiotic consumption—an interrupted time series analysis of the early and late phases of the covid-19 pandemic in poland, a retrospective study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10073786/ https://www.ncbi.nlm.nih.gov/pubmed/37017868 http://dx.doi.org/10.1007/s43440-023-00479-z |
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