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Coronavirus Disease 2019 Vaccination Is Associated With Reduced Outpatient Antibiotic Prescribing in Older Adults With Confirmed Severe Acute Respiratory Syndrome Coronavirus 2: A Population-Wide Cohort Study.
MacFadden, Derek R; Maxwell, Colleen; Bowdish, Dawn; Bronskill, Susan; Brooks, James; Brown, Kevin; Burrows, Lori L; Clarke, Anna; Langford, Bradley; Leung, Elizabeth; Leung, Valerie; Manuel, Doug; McGeer, Allison; Mishra, Sharmistha; Morris, Andrew M; Nott, Caroline; Raybardhan, Sumit; Sapin, Mia; Schwartz, Kevin L; So, Miranda; Soucy, Jean-Paul R; Daneman, Nick.
Afiliación
  • MacFadden DR; Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, Canada.
  • Maxwell C; ICES, Toronto, Canada.
  • Bowdish D; Division of Infectious Diseases, The Ottawa Hospital, Ottawa, Canada.
  • Bronskill S; ICES, Toronto, Canada.
  • Brooks J; Schools of Pharmacy and Public Health Sciences, University of Waterloo, Waterloo, Canada.
  • Brown K; Faculty of Health Sciences, McMaster University, Hamilton, Canada.
  • Burrows LL; ICES, Toronto, Canada.
  • Clarke A; Division of Infectious Diseases, The Ottawa Hospital, Ottawa, Canada.
  • Langford B; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
  • Leung E; Public Health Ontario, Toronto, Canada.
  • Leung V; Faculty of Health Sciences, McMaster University, Hamilton, Canada.
  • Manuel D; ICES, Toronto, Canada.
  • McGeer A; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
  • Mishra S; Public Health Ontario, Toronto, Canada.
  • Morris AM; Unity Health Toronto, Toronto, Canada.
  • Nott C; Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada.
  • Raybardhan S; Public Health Ontario, Toronto, Canada.
  • Sapin M; Michael Garron Hospital, Toronto East Health Network, Toronto, Canada.
  • Schwartz KL; ICES, Toronto, Canada.
  • So M; Sinai Health System, Toronto, Canada.
  • Soucy JR; ICES, Toronto, Canada.
  • Daneman N; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
Clin Infect Dis ; 77(3): 362-370, 2023 08 14.
Article en En | MEDLINE | ID: mdl-36999314
BACKGROUND: Antibiotics are frequently prescribed unnecessarily in outpatients with coronavirus disease 2019 (COVID-19). We sought to evaluate factors associated with antibiotic prescribing in outpatients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. METHODS: We performed a population-wide cohort study of outpatients aged ≥66 years with polymerase chain reaction-confirmed SARS-CoV-2 from 1 January 2020 to 31 December 2021 in Ontario, Canada. We determined rates of antibiotic prescribing within 1 week before (prediagnosis) and 1 week after (postdiagnosis) reporting of the positive SARS-CoV-2 result, compared to a self-controlled period (baseline). We evaluated predictors of prescribing, including a primary-series COVID-19 vaccination, in univariate and multivariable analyses. RESULTS: We identified 13 529 eligible nursing home residents and 50 885 eligible community-dwelling adults with SARS-CoV-2 infection. Of the nursing home and community residents, 3020 (22%) and 6372 (13%), respectively, received at least 1 antibiotic prescription within 1 week of a SARS-CoV-2 positive result. Antibiotic prescribing in nursing home and community residents occurred, respectively, at 15.0 and 10.5 prescriptions per 1000 person-days prediagnosis and 20.9 and 9.8 per 1000 person-days postdiagnosis, higher than the baseline rates of 4.3 and 2.5 prescriptions per 1000 person-days. COVID-19 vaccination was associated with reduced prescribing in nursing home and community residents, with adjusted postdiagnosis incidence rate ratios (95% confidence interval) of 0.7 (0.4-1) and 0.3 (0.3-0.4), respectively. CONCLUSIONS: Antibiotic prescribing was high and with little or no decline following SARS-CoV-2 diagnosis but was reduced in COVID-19-vaccinated individuals, highlighting the importance of vaccination and antibiotic stewardship in older adults with COVID-19.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: COVID-19 Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Humans País/Región como asunto: America do norte Idioma: En Revista: Clin Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS Año: 2023 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: COVID-19 Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Humans País/Región como asunto: America do norte Idioma: En Revista: Clin Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS Año: 2023 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Estados Unidos