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Stemming the Rise of Antibiotic Use for Community-Acquired Acute Respiratory Infections during COVID-19 Pandemic.
Lim, Shena Y C; Zhou, Yvonne P; Yii, Daphne; Chin, De Zhi; Hung, Kai Chee; Lee, Lai Wei; Lim, Jia Le; Loo, Li Wen; Koomanan, Narendran; Chua, Nathalie Grace; Liew, Yixin; Cherng, Benjamin P Z; Thien, Siew Yee; Lee, Winnie H L; Kwa, Andrea L H; Chung, Shimin J.
  • Lim SYC; Department of Pharmacy, Singapore General Hospital, Singapore 169608, Singapore.
  • Zhou YP; Department of Pharmacy, Singapore General Hospital, Singapore 169608, Singapore.
  • Yii D; Department of Pharmacy, Singapore General Hospital, Singapore 169608, Singapore.
  • Chin Z; Department of Clinical Quality and Performance Management, Singapore General Hospital, Singapore 169608, Singapore.
  • Hung KC; Department of Pharmacy, Singapore General Hospital, Singapore 169608, Singapore.
  • Lee LW; Department of Pharmacy, Singapore General Hospital, Singapore 169608, Singapore.
  • Lim JL; Department of Pharmacy, Singapore General Hospital, Singapore 169608, Singapore.
  • Loo LW; Department of Pharmacy, Singapore General Hospital, Singapore 169608, Singapore.
  • Koomanan N; Department of Pharmacy, Singapore General Hospital, Singapore 169608, Singapore.
  • Chua NG; Department of Pharmacy, Singapore General Hospital, Singapore 169608, Singapore.
  • Liew Y; Department of Pharmacy, Singapore General Hospital, Singapore 169608, Singapore.
  • Cherng BPZ; Department of Infectious Diseases, Singapore General Hospital, Singapore 169608, Singapore.
  • Thien SY; Department of Infectious Diseases, Singapore General Hospital, Singapore 169608, Singapore.
  • Lee WHL; Department of Pharmacy, Singapore General Hospital, Singapore 169608, Singapore.
  • Kwa ALH; Department of Pharmacy, Singapore General Hospital, Singapore 169608, Singapore.
  • Chung SJ; Department of Infectious Diseases, Singapore General Hospital, Singapore 169608, Singapore.
Antibiotics (Basel) ; 11(7)2022 Jun 24.
Article in English | MEDLINE | ID: covidwho-1911149
ABSTRACT
At the start of the COVID-19 pandemic, there was an increase in the use of antibiotics for the treatment of community-acquired respiratory tract infection (CA-ARI) in patients admitted for suspected or confirmed COVID-19, raising concerns for misuse. These antibiotics are not under the usual purview of the antimicrobial stewardship unit (ASU). Serum procalcitonin, a biomarker to distinguish viral from bacterial infections, can be used to guide antibiotic recommendations in suspected lower respiratory tract infection. We modified our stewardship approach, and used a procalcitonin-guided strategy to identify "high yield" interventions for audits in patients admitted with CA-ARI. With this approach, there was an increase in the proportion of patients with antibiotics discontinued within 4 days (16.5% vs. 34.9%, p < 0.001), and the overall duration of antibiotic therapy was significantly shorter [7 (6-8) vs. 6 (3-8) days, p < 0.001]. There was a significant decrease in patients with intravenous-to-oral switch of antibiotics to "complete the course" (45.3% vs. 34.4%, p < 0.05). Of the patients who had antibiotics discontinued, none were restarted on antibiotics within 48 h, and there was no-30-day readmission or 30-day mortality attributed to respiratory infection. This study illustrates the importance of the antimicrobial stewardship during the pandemic and the need for ASU to remain attuned to prescriber's practices, and adapt accordingly to address antibiotic misuse to curb antimicrobial resistance.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Prognostic study Language: English Year: 2022 Document Type: Article Affiliation country: Antibiotics11070846

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Prognostic study Language: English Year: 2022 Document Type: Article Affiliation country: Antibiotics11070846