Antibiotic Use During the First 6 Months of Covid-19 Pandemic in Iran: A Large-Scale Multi-Centre Study Publisher Pubmed



Salehi M¹ ; Khalili H² ; Seifi A¹ ; Davoudi H³ ; Darazam IA⁴ ; Jahangardrafsanjani Z² ; Mohammadnejad E⁵ ; Heydari B⁶ ; Siahkaly SJM⁷ ; Tabarsi P⁸ ; Kalantari S⁹ ; Menshadi SAD¹ ; Babamahmoodi F¹⁰ ; Khorvash F¹¹ Show All Authors
Source: Journal of Clinical Pharmacy and Therapeutics Published:2022

Abstract

What is known and objective: Although antibiotics are ineffective against viral infections, epidemiological studies have revealed that the COVID-19 pandemic resulted in the overuse of antibiotics and disruption of antimicrobial stewardship programmes. We investigated the pattern of antibiotic use during the first 6 months of the COVID-19 pandemic in Iran. Methods: A multi-centre retrospective study was designed to investigate the use of 16 broad-spectrum antibiotics in 12 medical centres. The rate of antibiotic use was calculated and reported based on the Defined Daily Dose (DDD) per 100 hospital bed-days. The bacterial co-infection rate was also reported. Results and discussion: Totally, 43,791 hospitalized COVID-19 patients were recruited in this study. It was found that 121.6 DDD of antibiotics were used per 100 hospital bed-days, which estimated that each patient received approximately 1.21 DDDs of antibiotics every day. However, the bacterial co-infections were detected only in 14.4% of the cases. A direct correlation was observed between the rate of antibiotic use and mortality (r[142] = 0.237, p = 0.004). The rate of antibiotic consumption was not significantly different between the ICU and non-ICU settings (p = 0.15). What is new and conclusion: In this study, widespread antibiotic use was detected in the absence of the confirmed bacterial coinfection in COVID-19 patients. This over-consumption of broad-spectrum antibiotics may be associated with increased mortality in hospitalized COVID-19 patients, which can be an alarming finding. © 2022 John Wiley & Sons Ltd.