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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
Authors
  1. Salehi M1
  2. Khalili H2
  3. Seifi A1
  4. Davoudi H3
  5. Darazam IA4
  6. Jahangardrafsanjani Z2
  7. Mohammadnejad E5
  8. Heydari B6
  9. Siahkaly SJM7
  10. Tabarsi P8
  11. Kalantari S9
  12. Menshadi SAD1
  13. Babamahmoodi F10
  14. Khorvash F11
  15. Davarpanah MA12
  16. Soltani R13
  17. Yaghoobi MH14
  18. Anari SAM15
  19. Khodadadi J16
  20. Aliramezani A17
  21. Hantooshzadeh S18
  22. Naderi HR19
  23. Hajiabdolbaghi M1
  24. Elyasi S20
  25. Firouzabadi D21
  26. Kasgari HA22
  27. Roshanzamiri S23
  28. Ebrahimpour S24
Show Affiliations
Authors Affiliations
  1. 1. Infectious Diseases Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Pharmaceutical Care, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Department of Infectious Disease, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  5. 5. Department of Medical-Surgical Nursing and Basic Sciences, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
  6. 6. Department of Clinical Pharmacy, School of Pharmacy, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
  7. 7. Department of Infectious Disease, School of Medicine, Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran
  8. 8. Department of Infectious Disease, School of Medicine, National Research Institute of Tuberculosis and Lung Diseases, Dr. Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  9. 9. Department of Infectious Disease, School of Medicine, Hazrat-e Rasool General Hospital, Iran University of Medical Sciences, Tehran, Iran
  10. 10. Department of Infectious Diseases, Antimicrobial Resistance Research Center, Communicable Diseases Institute, Ghaem Shahr Razi Hospital, Mazandaran University of Medical Sciences, Mazandaran, Sari, Iran
  11. 11. Department of Infectious Diseases and Tropical Medicine, Nosocomial Infection Research Center, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
  12. 12. Department of Internal Medicine, HIV/AIDS Research Center, Research Institute for Health, Namazi Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
  13. 13. Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
  14. 14. Department of Infectious Diseases, School of Medicine, Alborz University of Medical Sciences, Alborz, Karaj, Iran
  15. 15. Department of Infectious Disease, Infectious Diseases Research Center, Shahid Sadoughi General Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
  16. 16. Department of Infectious Disease, Kamkar-Arabnia Hospital, Qom University of Medical Sciences, Qom, Iran
  17. 17. Department of Microbiology, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  18. 18. Department of Obstetrics and Gynecology, School of Medicine, Family Health Research Institute, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
  19. 19. Department of Infectious Disease, Surgical Oncology Research Center, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
  20. 20. Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
  21. 21. Department of Clinical Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
  22. 22. Department of Clinical Pharmacy, School of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
  23. 23. Department of Clinical Pharmacy, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  24. 24. Department of Clinical Pharmacy, School of Pharmacy, Alborz University of Medical Sciences, Alborz, Iran

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.
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