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The Impact of COVID-19 on Outpatient Antibiotic Prescriptions in Ontario, Canada; An Interrupted Time Series Analysis.
Kitano, Taito; Brown, Kevin A; Daneman, Nick; MacFadden, Derek R; Langford, Bradley J; Leung, Valerie; So, Miranda; Leung, Elizabeth; Burrows, Lori; Manuel, Douglas; Bowdish, Dawn M E; Maxwell, Colleen J; Bronskill, Susan E; Brooks, James I; Schwartz, Kevin L.
  • Kitano T; The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
  • Brown KA; Public Health Ontario, Toronto, Ontario, Canada.
  • Daneman N; Public Health Ontario, Toronto, Ontario, Canada.
  • MacFadden DR; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
  • Langford BJ; ICES, Toronto, Ontario, Canada.
  • Leung V; Public Health Ontario, Toronto, Ontario, Canada.
  • So M; ICES, Toronto, Ontario, Canada.
  • Leung E; Sunnybrook Research Institute, Toronto, Ontario, Canada.
  • Burrows L; ICES, Toronto, Ontario, Canada.
  • Manuel D; Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada.
  • Bowdish DME; Public Health Ontario, Toronto, Ontario, Canada.
  • Maxwell CJ; Public Health Ontario, Toronto, Ontario, Canada.
  • Bronskill SE; Toronto East Health Network, Michael Garron Hospital, Toronto, Ontario, Canada.
  • Brooks JI; Sinai Health System-University Health Network Antimicrobial Stewardship Program, Toronto, Ontario, Canada.
  • Schwartz KL; Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada.
Open Forum Infect Dis ; 8(11): ofab533, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1528174
ABSTRACT

Background:

The coronavirus disease 2019 (COVID-19) pandemic has potentially impacted outpatient antibiotic prescribing. Investigating this impact may identify stewardship opportunities in the ongoing COVID-19 period and beyond.

Methods:

We conducted an interrupted time series analysis on outpatient antibiotic prescriptions and antibiotic prescriptions/patient visits in Ontario, Canada, between January 2017 and December 2020 to evaluate the impact of the COVID-19 pandemic on population-level antibiotic prescribing by prescriber specialty, patient demographics, and conditions.

Results:

In the evaluated COVID-19 period (March-December 2020), there was a 31.2% (95% CI, 27.0% to 35.1%) relative reduction in total antibiotic prescriptions. Total outpatient antibiotic prescriptions decreased during the COVID-19 period by 37.1% (95% CI, 32.5% to 41.3%) among family physicians, 30.7% (95% CI, 25.8% to 35.2%) among subspecialist physicians, 12.1% (95% CI, 4.4% to 19.2%) among dentists, and 25.7% (95% CI, 21.4% to 29.8%) among other prescribers. Antibiotics indicated for respiratory infections decreased by 43.7% (95% CI, 38.4% to 48.6%). Total patient visits and visits for respiratory infections decreased by 10.7% (95% CI, 5.4% to 15.6%) and 49.9% (95% CI, 43.1% to 55.9%). Total antibiotic prescriptions/1000 visits decreased by 27.5% (95% CI, 21.5% to 33.0%), while antibiotics indicated for respiratory infections/1000 visits with respiratory infections only decreased by 6.8% (95% CI, 2.7% to 10.8%).

Conclusions:

The reduction in outpatient antibiotic prescribing during the COVID-19 pandemic was driven by less antibiotic prescribing for respiratory indications and largely explained by decreased visits for respiratory infections.
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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Language: English Journal: Open Forum Infect Dis Year: 2021

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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Language: English Journal: Open Forum Infect Dis Year: 2021
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