ABSTRACT
BACKGROUND: Antibiotic and antiviral agents may be prescribed in patients with suspected or confirmed coronavirus disease 2019 (COVID-19) infections because of in vitro evidence of cessation of viral replication, potential bacterial secondary or coinfection, and inability to distinguish COVID-19 infections from common bacterial infections. The objective of this study was to evaluate antimicrobial prescribing patterns in the outpatient setting during the initial peak of COVID-19 in New York City. METHODS: This single-center, retrospective chart review included patients at least 18 years old who were prescribed oral antimicrobial agents in outpatient primary care clinics between March and May 2020. Data were compared with prescribing patterns from March to May 2019. The primary outcome was the number of antimicrobial prescriptions per 1000 patient visits. Secondary outcomes included documented indication, incidence of confirmed infections, mortality, and/or hospital admission within 90 days. Descriptive statistics were used. RESULTS: The overall antimicrobial prescribing rate increased from 31.94 prescriptions per 1000 visits in 2019 to 57.48 prescriptions per 1000 visits in 2020. Agents that were more commonly prescribed during the initial peak of COVID-19 include cefpodoxime, hydroxychloroquine, doxycycline, and sulfamethoxazole-trimethoprim. COVID-19 represented 7 (6%) documented antimicrobial indications in 2020, with agents such as azithromycin, hydroxychloroquine, doxycycline, cefpodoxime, and oseltamivir prescribed. CONCLUSIONS: Overall antimicrobial prescribing rates in outpatient primary care clinics increased during the first peak of COVID-19 in an area with high infection burden. This increase may have been influenced by restricted patient evaluation, changes in patient management, and a decrease in overall patient visits.
ABSTRACT
INTRODUCTION: The purpose of this study was to design, pilot, and evaluate the efficacy of an educational escape room to enhance second professional year doctor of pharmacy students' knowledge of heart failure medicinal chemistry, pharmacology, and therapeutics in an integrated Modular Organ Systems Therapeutics (MOST) course and to assess students' perceptions of the game. METHODS: Heart failure pharmacology, medicinal chemistry, and pharmacotherapeutics were taught in MOST prior to the escape room activity. Students were randomized into groups of approximately eight. At the completion of the activity, students were asked to fill out a perceptions survey. A follow up survey of their perceptions was again administered four weeks after the activity. RESULTS: One-hundred-ninety-three students participated in the escape room activity. Overall, performance indicated that the escape room satisfactorily reinforced students' learning of the course material. Students expressed satisfaction toward the escape room activity on both surveys, with response rates of 92.22% and 56.99% for the initial and follow up surveys, respectively. Findings revealed no statistically significant differences between the first and the second group of responses, confirming that positive attitudes toward the activity did not alter over time. Students' satisfaction levels were inversely related to their grade point average (r = -0.20, p = 0.05). CONCLUSIONS: Positive student perceptions reported immediately after the completion of the escape room activity and measured in the follow-up survey demonstrated that the escape room is a satisfying learning activity that can engage all students.
