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Antibiotic Overprescribing among Neonates and Children Hospitalized with COVID-19 in Pakistan and the Implications

There are concerns with excessive antibiotic prescribing among patients admitted to hospital with COVID-19, increasing antimicrobial resistance (AMR). Most studies have been conducted in adults with limited data on neonates and children, including in Pakistan. A retrospective study was conducted amo...

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Autores principales: Mustafa, Zia UI, Khan, Amer Hayat, Harun, Sabariah Noor, Salman, Muhammad, Godman, Brian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10135218/
https://www.ncbi.nlm.nih.gov/pubmed/37107008
http://dx.doi.org/10.3390/antibiotics12040646
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author Mustafa, Zia UI
Khan, Amer Hayat
Harun, Sabariah Noor
Salman, Muhammad
Godman, Brian
author_facet Mustafa, Zia UI
Khan, Amer Hayat
Harun, Sabariah Noor
Salman, Muhammad
Godman, Brian
author_sort Mustafa, Zia UI
collection PubMed
description There are concerns with excessive antibiotic prescribing among patients admitted to hospital with COVID-19, increasing antimicrobial resistance (AMR). Most studies have been conducted in adults with limited data on neonates and children, including in Pakistan. A retrospective study was conducted among four referral/tertiary care hospitals, including the clinical manifestations, laboratory findings, the prevalence of bacterial co-infections or secondary bacterial infections and antibiotics prescribed among neonates and children hospitalized due to COVID-19. Among 1237 neonates and children, 511 were admitted to the COVID-19 wards and 433 were finally included in the study. The majority of admitted children were COVID-19-positive (85.9%) with severe COVID-19 (38.2%), and 37.4% were admitted to the ICU. The prevalence of bacterial co-infections or secondary bacterial infections was 3.7%; however, 85.5% were prescribed antibiotics during their hospital stay (average 1.70 ± 0.98 antibiotics per patient). Further, 54.3% were prescribed two antibiotics via the parenteral route (75.5%) for ≤5 days (57.5), with most being ‘Watch’ antibiotics (80.4%). Increased antibiotic prescribing was reported among patients requiring mechanical ventilation and high WBCs, CRP, D-dimer and ferritin levels (p < 0.001). Increased COVID-19 severity, length of stay and hospital setting were significantly associated with antibiotic prescribing (p < 0.001). Excessive antibiotic prescribing among hospitalized neonates and children, despite very low bacterial co-infections or secondary bacterial infections, requires urgent attention to reduce AMR.
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spelling pubmed-101352182023-04-28 Antibiotic Overprescribing among Neonates and Children Hospitalized with COVID-19 in Pakistan and the Implications Mustafa, Zia UI Khan, Amer Hayat Harun, Sabariah Noor Salman, Muhammad Godman, Brian Antibiotics (Basel) Article There are concerns with excessive antibiotic prescribing among patients admitted to hospital with COVID-19, increasing antimicrobial resistance (AMR). Most studies have been conducted in adults with limited data on neonates and children, including in Pakistan. A retrospective study was conducted among four referral/tertiary care hospitals, including the clinical manifestations, laboratory findings, the prevalence of bacterial co-infections or secondary bacterial infections and antibiotics prescribed among neonates and children hospitalized due to COVID-19. Among 1237 neonates and children, 511 were admitted to the COVID-19 wards and 433 were finally included in the study. The majority of admitted children were COVID-19-positive (85.9%) with severe COVID-19 (38.2%), and 37.4% were admitted to the ICU. The prevalence of bacterial co-infections or secondary bacterial infections was 3.7%; however, 85.5% were prescribed antibiotics during their hospital stay (average 1.70 ± 0.98 antibiotics per patient). Further, 54.3% were prescribed two antibiotics via the parenteral route (75.5%) for ≤5 days (57.5), with most being ‘Watch’ antibiotics (80.4%). Increased antibiotic prescribing was reported among patients requiring mechanical ventilation and high WBCs, CRP, D-dimer and ferritin levels (p < 0.001). Increased COVID-19 severity, length of stay and hospital setting were significantly associated with antibiotic prescribing (p < 0.001). Excessive antibiotic prescribing among hospitalized neonates and children, despite very low bacterial co-infections or secondary bacterial infections, requires urgent attention to reduce AMR. MDPI 2023-03-24 /pmc/articles/PMC10135218/ /pubmed/37107008 http://dx.doi.org/10.3390/antibiotics12040646 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. 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/).
spellingShingle Article
Mustafa, Zia UI
Khan, Amer Hayat
Harun, Sabariah Noor
Salman, Muhammad
Godman, Brian
Antibiotic Overprescribing among Neonates and Children Hospitalized with COVID-19 in Pakistan and the Implications
title Antibiotic Overprescribing among Neonates and Children Hospitalized with COVID-19 in Pakistan and the Implications
title_full Antibiotic Overprescribing among Neonates and Children Hospitalized with COVID-19 in Pakistan and the Implications
title_fullStr Antibiotic Overprescribing among Neonates and Children Hospitalized with COVID-19 in Pakistan and the Implications
title_full_unstemmed Antibiotic Overprescribing among Neonates and Children Hospitalized with COVID-19 in Pakistan and the Implications
title_short Antibiotic Overprescribing among Neonates and Children Hospitalized with COVID-19 in Pakistan and the Implications
title_sort antibiotic overprescribing among neonates and children hospitalized with covid-19 in pakistan and the implications
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10135218/
https://www.ncbi.nlm.nih.gov/pubmed/37107008
http://dx.doi.org/10.3390/antibiotics12040646
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