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Comparative antimicrobial use in coronavirus disease 2019 (COVID-19) and non–COVID-19 inpatients from 2019 to 2020: A multicenter ecological study

Published online by Cambridge University Press:  25 October 2023

Carlos A.Q. Santos Open the ORCID record for Carlos A.Q. Santos [Opens in a new window] ,
Marion Tseng ,
Ashley I. Martinez ,
Shivanjali Shankaran Open the ORCID record for Shivanjali Shankaran [Opens in a new window] ,
Hayley A. Hodgson ,
Faraz S. Ahmad ,
Huiyuan Zhang ,
Dawn M. Sievert  and
William E. Trick Open the ORCID record for William E. Trick [Opens in a new window]
Carlos A.Q. Santos*
Affiliation:
Division of Infectious Diseases, Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois
Marion Tseng
Affiliation:
Medical Research Analytics and Informatics Alliance, Chicago, Illinois
Ashley I. Martinez
Affiliation:
Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois Division of Therapeutics and Infectious Disease Epidemiology, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
Shivanjali Shankaran
Affiliation:
Division of Infectious Diseases, Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois
Hayley A. Hodgson
Affiliation:
Department of Pharmacy, Rush University Medical Center, Chicago, Illinois
Faraz S. Ahmad
Affiliation:
Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
Huiyuan Zhang
Affiliation:
Center for Health Equity & Innovation, Cook County Health, Chicago, Illinois
Dawn M. Sievert
Affiliation:
Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
William E. Trick
Affiliation:
Center for Health Equity & Innovation, Cook County Health, Chicago, Illinois Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois
*
Author for correspondence: Carlos A. Q. Santos, MD, MPHS, Division of Infectious Diseases, Department of Internal Medicine, Rush University Medical Center, 600 S Paulina St, Suite 143, Chicago, IL 60612. E-mail: Carlos_A_Santos@rush.edu
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Abstract

Objective:

We sought to determine whether increased antimicrobial use (AU) at the onset of the coronavirus disease 2019 (COVID-19) pandemic was driven by greater AU in COVID-19 patients only, or whether AU also increased in non–COVID-19 patients.

Design:

In this retrospective observational ecological study from 2019 to 2020, we stratified inpatients by COVID-19 status and determined relative percentage differences in median monthly AU in COVID-19 patients versus non–COVID-19 patients during the COVID-19 period (March–December 2020) and the pre–COVID-19 period (March–December 2019). We also determined relative percentage differences in median monthly AU in non–COVID-19 patients during the COVID-19 period versus the pre–COVID-19 period. Statistical significance was assessed using Wilcoxon signed-rank tests.

Setting:

The study was conducted in 3 acute-care hospitals in Chicago, Illinois.

Patients:

Hospitalized patients.

Results:

Facility-wide AU for broad-spectrum antibacterial agents predominantly used for hospital-onset infections was significantly greater in COVID-19 patients versus non–COVID-19 patients during the COVID-19 period (with relative increases of 73%, 66%, and 91% for hospitals A, B, and C, respectively), and during the pre–COVID-19 period (with relative increases of 52%, 64%, and 66% for hospitals A, B, and C, respectively). In contrast, facility-wide AU for all antibacterial agents was significantly lower in non–COVID-19 patients during the COVID-19 period versus the pre–COVID-19 period (with relative decreases of 8%, 7%, and 8% in hospitals A, B, and C, respectively).

Conclusions:

AU for broad-spectrum antimicrobials was greater in COVID-19 patients compared to non–COVID-19 patients at the onset of the pandemic. AU for all antibacterial agents in non–COVID-19 patients decreased in the COVID-19 period compared to the pre–COVID-19 period.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 45 , Issue 3 , March 2024 , pp. 335 - 342
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Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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