Shiloh
Editor, Senior Moderator
Source: https://www.cidrap.umn.edu/news-perspective/2022/02/stewardship-resistance-scan-feb-18-2022
Stewardship / Resistance Scan for Feb 18, 2022
Pre-pandemic antimicrobial consumption; COVID-19 antibiotic use in Japan, Hong Kong
Filed Under:
Antimicrobial Stewardship; COVID-19
Study shows pre-pandemic global decline in antimicrobial use
An analysis of prescribing data from more than 80 countries found that global antimicrobial consumption declined prior to the COVID-19 pandemic, researchers reported today in the Journal of Antimicrobial Chemotherapy.
For the cross-sectional time-series analysis, researchers from the University of Pittsburgh and the University of Toronto obtained data on global monthly purchases of antimicrobials (antibiotics, antivirals, and antifungals) from 2014 through 2020 from the IQVIA MIDAS database, which contains monthly drug data for 84 countries. Their aim was to evaluate antimicrobial consumption pre-pandemic and assess the impact of the World Health Organization (WHO) Global Action Plan on Antimicrobial Resistance (GAP-AMR), which was adopted in 2015 to encourage countries to develop national AMR action plans.
Over the study period, the worldwide monthly antimicrobial purchase rate averaged 112.9 units per 1,000 population, with antibiotics accounting for 88.7% of antimicrobial consumption. Prior to the pandemic, the average monthly antimicrobial consumption rate in developed countries changed by –8.4%, compared with –1.2% in developing countries. Among countries with an AMR national action plan, all but five experienced a decline in average monthly antibiotic consumption pre-pandemic.
Global antimicrobial consumption increased by 11.2% from March 2019 to March 2020. The greatest increase was for antivirals in both developed (48.2%) and developing countries (110%), followed by antibiotics (6.9% and 5.9%, respectively). But from April to August 2020, antimicrobial consumption decreased worldwide by 18.7% compared with the previous year, with antibiotic consumption declining in both developed (–28%) and developing (–16.8%) countries.
The study authors say the findings show a promising decline in antimicrobial consumption pre-pandemic. And the decline in antibiotic use after the initial months of the pandemic, when it became clear that antibiotics were not effective against COVID-19, suggests that antibiotic stewardship efforts have not been derailed by the pandemic. But they warn that increases in antiviral use require attention.
"Antimicrobial consumption was decreasing across the globe pre-pandemic, especially for antibiotics, suggesting a positive impact of the WHO GAP-AMR," the study authors write. "AMR plans should include specific measures to ensure continued AMR efforts are fully implemented and continued during health crises such as the COVID-19 pandemic."
Feb 18 J Antimicrob Chemother study
Studies find lower antibiotic use in COVID patients in Hong Kong, Japan
Two new studies of COVID-19 patients in Japan and Hong Kong found low rates of concurrent bacterial infections and lower rates of antibiotic use than have been previously reported.
While previous studies have found low rates of bacterial co-infections in COVID-19 patients throughout the pandemic, they have also found high rates of antibiotic use, particularly in the early months of the pandemic. A meta-analysis of 24 studies found that roughly 72% of COVID-19 patients treated from Dec 25, 2019, through Mar 31, 2020, received antibiotics. Secondary bacterial infection was found in 14.3% of patients.
But in a letter published yesterday in the Journal of Infection, researchers reported that, among 11,004 COVID-19 patients hospitalized in Hong Kong from the beginning of the pandemic through Mar 3, 2021, 29.1% were treated with antibiotics, and only 1.84% had bacterial co-infections. Antibiotic use was common in patients without any co-infection (66.1%) or when co-infection was uncertain (13.7%). The authors note that antibiotic use may have been lower than found in previous studies because Hong Kong uses hospitalization as an isolation strategy, and many of the patients had mild or asymptomatic cases.
In a study of patients treated at Japan's National Hospital Organization Tochigi Medical Center from Nov 1, 2020, through Oct 9, 2021, published today in JAMA Network Open, researchers found that of 1,056 patients analyzed, only 18 (1.7%) received any antibiotics during hospitalization. Of these 18 patients, 15 used antibiotics for treatment and 3 used them as a prophylaxis.
Most of the patients (80%) had mild or moderate COVID-19. Seven microbiologically confirmed infectious diseases other than COVID-19 were detected in 6 patients (0.6%) during hospitalization.
"Given that most patients with noncritical severity recovered without antimicrobial drugs, the use of most antimicrobial drugs to treat noncritical cases in many hospitals might be unnecessary," the authors write. "Antimicrobial drugs should be used cautiously to treat patients with COVID-19 infection."
Feb 17 J Infect letter
Feb 18 JAMA Netw Open research letter
Stewardship / Resistance Scan for Feb 18, 2022
Pre-pandemic antimicrobial consumption; COVID-19 antibiotic use in Japan, Hong Kong
Filed Under:
Antimicrobial Stewardship; COVID-19
Study shows pre-pandemic global decline in antimicrobial use
An analysis of prescribing data from more than 80 countries found that global antimicrobial consumption declined prior to the COVID-19 pandemic, researchers reported today in the Journal of Antimicrobial Chemotherapy.
For the cross-sectional time-series analysis, researchers from the University of Pittsburgh and the University of Toronto obtained data on global monthly purchases of antimicrobials (antibiotics, antivirals, and antifungals) from 2014 through 2020 from the IQVIA MIDAS database, which contains monthly drug data for 84 countries. Their aim was to evaluate antimicrobial consumption pre-pandemic and assess the impact of the World Health Organization (WHO) Global Action Plan on Antimicrobial Resistance (GAP-AMR), which was adopted in 2015 to encourage countries to develop national AMR action plans.
Over the study period, the worldwide monthly antimicrobial purchase rate averaged 112.9 units per 1,000 population, with antibiotics accounting for 88.7% of antimicrobial consumption. Prior to the pandemic, the average monthly antimicrobial consumption rate in developed countries changed by –8.4%, compared with –1.2% in developing countries. Among countries with an AMR national action plan, all but five experienced a decline in average monthly antibiotic consumption pre-pandemic.
Global antimicrobial consumption increased by 11.2% from March 2019 to March 2020. The greatest increase was for antivirals in both developed (48.2%) and developing countries (110%), followed by antibiotics (6.9% and 5.9%, respectively). But from April to August 2020, antimicrobial consumption decreased worldwide by 18.7% compared with the previous year, with antibiotic consumption declining in both developed (–28%) and developing (–16.8%) countries.
The study authors say the findings show a promising decline in antimicrobial consumption pre-pandemic. And the decline in antibiotic use after the initial months of the pandemic, when it became clear that antibiotics were not effective against COVID-19, suggests that antibiotic stewardship efforts have not been derailed by the pandemic. But they warn that increases in antiviral use require attention.
"Antimicrobial consumption was decreasing across the globe pre-pandemic, especially for antibiotics, suggesting a positive impact of the WHO GAP-AMR," the study authors write. "AMR plans should include specific measures to ensure continued AMR efforts are fully implemented and continued during health crises such as the COVID-19 pandemic."
Feb 18 J Antimicrob Chemother study
Studies find lower antibiotic use in COVID patients in Hong Kong, Japan
Two new studies of COVID-19 patients in Japan and Hong Kong found low rates of concurrent bacterial infections and lower rates of antibiotic use than have been previously reported.
While previous studies have found low rates of bacterial co-infections in COVID-19 patients throughout the pandemic, they have also found high rates of antibiotic use, particularly in the early months of the pandemic. A meta-analysis of 24 studies found that roughly 72% of COVID-19 patients treated from Dec 25, 2019, through Mar 31, 2020, received antibiotics. Secondary bacterial infection was found in 14.3% of patients.
But in a letter published yesterday in the Journal of Infection, researchers reported that, among 11,004 COVID-19 patients hospitalized in Hong Kong from the beginning of the pandemic through Mar 3, 2021, 29.1% were treated with antibiotics, and only 1.84% had bacterial co-infections. Antibiotic use was common in patients without any co-infection (66.1%) or when co-infection was uncertain (13.7%). The authors note that antibiotic use may have been lower than found in previous studies because Hong Kong uses hospitalization as an isolation strategy, and many of the patients had mild or asymptomatic cases.
In a study of patients treated at Japan's National Hospital Organization Tochigi Medical Center from Nov 1, 2020, through Oct 9, 2021, published today in JAMA Network Open, researchers found that of 1,056 patients analyzed, only 18 (1.7%) received any antibiotics during hospitalization. Of these 18 patients, 15 used antibiotics for treatment and 3 used them as a prophylaxis.
Most of the patients (80%) had mild or moderate COVID-19. Seven microbiologically confirmed infectious diseases other than COVID-19 were detected in 6 patients (0.6%) during hospitalization.
"Given that most patients with noncritical severity recovered without antimicrobial drugs, the use of most antimicrobial drugs to treat noncritical cases in many hospitals might be unnecessary," the authors write. "Antimicrobial drugs should be used cautiously to treat patients with COVID-19 infection."
Feb 17 J Infect letter
Feb 18 JAMA Netw Open research letter