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Trends in Inpatient Antibiotic Use Among Adults Hospitalized During the Coronavirus Disease 2019 Pandemic in Argentina, Brazil, and Chile, 2018-2021.
Patel, Twisha S; McGovern, Olivia L; Mahon, Garrett; Osuka, Hanako; Boszczowski, Icaro; Munita, Jose M; Garzon, Maria Isabel; Salomao, Matias C; Marssola, Giovanna; Tavares, Bruno M; Francisco, Debora B; Gurgel, Alessandra P A; Arantes, Tiago; Bori, Andrea; Nogueira, Cassimiro; Peters, Anne; Spencer, Maria; Orellana, Cristian; Barbe, Mario; Lopez, Constanza; Stender, Stacie; Lessa, Fernanda C.
Afiliação
  • Patel TS; International Infection Control Program, Division of Healthcare Quality Promotion, National Center for Emerging Zoonotic and Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
  • McGovern OL; Chenega Enterprise Systems and Solutions Chesapeake, Virginia, USA.
  • Mahon G; International Infection Control Program, Division of Healthcare Quality Promotion, National Center for Emerging Zoonotic and Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
  • Osuka H; International Infection Control Program, Division of Healthcare Quality Promotion, National Center for Emerging Zoonotic and Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
  • Boszczowski I; CACI International, Reston, Virginia, USA.
  • Munita JM; International Infection Control Program, Division of Healthcare Quality Promotion, National Center for Emerging Zoonotic and Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
  • Garzon MI; Chenega Enterprise Systems and Solutions Chesapeake, Virginia, USA.
  • Salomao MC; Department of Infection Control of Hospital das Clínicas, Faculdade de Medicina, Universidade de Sao Paulo, Sau Paulo, Brazil.
  • Marssola G; Hospital Alemão Oswaldo Cruz, São Paulo, Brazil.
  • Tavares BM; Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile.
  • Francisco DB; Millennium Initiative for Collaborative Research on Bacterial Resistance, Instituto de Ciencias e Innovación en Medicina, Facultad de Medicine, Clínica Alemana, Universidad del Desarrollo, Santiago, Chile.
  • Gurgel APA; Servicio de Infectología, Hospital Privado de Córdoba, Cordoba, Argentina.
  • Arantes T; Hospital Español, Córdoba, Argentina.
  • Bori A; Department of Infection Control of Hospital das Clínicas, Faculdade de Medicina, Universidade de Sao Paulo, Sau Paulo, Brazil.
  • Nogueira C; Hospital Alemão Oswaldo Cruz, São Paulo, Brazil.
  • Peters A; Department of Infection Control of Hospital das Clínicas, Faculdade de Medicina, Universidade de Sao Paulo, Sau Paulo, Brazil.
  • Spencer M; Hospital Alemão Oswaldo Cruz, São Paulo, Brazil.
  • Orellana C; Hospital Alemão Oswaldo Cruz, São Paulo, Brazil.
  • Barbe M; Hospital Alemão Oswaldo Cruz, São Paulo, Brazil.
  • Lopez C; Department of Infection Control of Hospital das Clínicas, Faculdade de Medicina, Universidade de Sao Paulo, Sau Paulo, Brazil.
  • Stender S; Department of Infection Control of Hospital das Clínicas, Faculdade de Medicina, Universidade de Sao Paulo, Sau Paulo, Brazil.
  • Lessa FC; Hospital Alemão Oswaldo Cruz, São Paulo, Brazil.
Clin Infect Dis ; 77(Suppl 1): S4-S11, 2023 07 05.
Article em En | MEDLINE | ID: mdl-37406043
BACKGROUND: High rates of antibiotic use (AU) among inpatients with coronavirus disease 2019 (COVID-19) despite low rates of bacterial coinfection and secondary infection have been reported. We evaluated the impact of the COVID-19 pandemic on AU in healthcare facilities (HCFs) in South America. METHODS: We conducted an ecologic evaluation of AU in inpatient adult acute care wards in 2 HCFs each in Argentina, Brazil, and Chile. The AU rates for intravenous antibiotics were calculated as the defined daily dose per 1000 patient-days, using pharmacy dispensing records and hospitalization data from March 2018-February 2020 (prepandemic) and March 2020-February 2021 (pandemic). Differences in median AU were compared between the prepandemic and pandemic periods, using the Wilcoxon rank sum test to determine significance. Interrupted time series analysis was used to analyze changes in AU during the COVID-19 pandemic. RESULTS: Compared with the prepandemic period, the median difference in AU rates for all antibiotics combined increased in 4 of 6 HCFs (percentage change, 6.7%-35.1%; P < .05). In the interrupted time series models, 5 of 6 HCFs had significant increases in use of all antibiotics combined immediately at the onset of the pandemic (immediate effect estimate range, 15.4-268), but only 1 of these 5 HCFs experienced a sustained increase over time (change in slope, +8.13; P < .01). The effect of the pandemic onset varied by antibiotic group and HCF. CONCLUSIONS: Substantial increases in AU were observed at the beginning of the COVID-19 pandemic, suggesting the need to maintain or strengthen antibiotic stewardship activities as part of pandemic or emergency HCF responses.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: COVID-19 / Antibacterianos Limite: Adult / Humans País/Região como assunto: America do sul / Argentina / Brasil / Chile Idioma: En Revista: Clin Infect Dis Assunto da revista: DOENCAS TRANSMISSIVEIS Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: COVID-19 / Antibacterianos Limite: Adult / Humans País/Região como assunto: America do sul / Argentina / Brasil / Chile Idioma: En Revista: Clin Infect Dis Assunto da revista: DOENCAS TRANSMISSIVEIS Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Estados Unidos