The impact of COVID-19 on community antibiotic use in Canada: an ecological study.
Antibiotic
Antibiotic use
Antimicrobial
Antimicrobial stewardship COVID-19
Epidemiology
Journal
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
ISSN: 1469-0691
Titre abrégé: Clin Microbiol Infect
Pays: England
ID NLM: 9516420
Informations de publication
Date de publication:
Mar 2022
Mar 2022
Historique:
received:
16
06
2021
revised:
15
10
2021
accepted:
22
10
2021
pubmed:
11
11
2021
medline:
16
3
2022
entrez:
10
11
2021
Statut:
ppublish
Résumé
The COVID-19 pandemic has had an effect on the incidence of infectious diseases and medical care. This study aimed to describe the impact of the COVID-19 pandemic on community-level antibiotic use. Using national antibiotic dispensing data from IQVIA's CompuScript database, this ecological study investigated antibiotic dispensing through community retail pharmacies in Canada from November 2014 to October 2020. Analyses were stratified by age, sex, prescription origin and approximate indication. Adjusting for seasonality, the national rate of antibiotic dispensing in Canada decreased by 26.5% (50.4 to 37.0 average prescriptions per 1000 inhabitants) during the first 8 months of the Canadian COVID-19 period (March to October 2020), compared with the pre-COVID-19 period. Prescribing rates in children ≤18 years decreased from 43.7 to 12.2 prescriptions per 1000 inhabitants in males (-72%) and from 46.8 to 14.9 prescriptions per 1000 inhabitants in females (-68%) in April 2020. Rates in adults ≥65 decreased from 74.9 to 48.8 prescriptions per 1000 inhabitants in males (-35%) and from 91.7 to 61.3 prescriptions per 1000 inhabitants in females (-33%) in May 2020. Antibiotic prescriptions from family physicians experienced a greater decrease than from surgeons and infectious disease physicians. Prescribing rates for antibiotics for respiratory indications decreased by 56% in May 2020 (29.2 to 12.8 prescriptions per 1000 inhabitants), compared with prescribing rates for urinary tract infections (9.4 to 7.8 prescriptions per 1000 inhabitants; -17%) and skin and soft tissue infections (6.4 to 5.2 prescriptions per 1000 inhabitants; -19%). The first 8 months of the COVID-19 pandemic reduced community antibiotic dispensing by 26.5% in Canada, compared with the marginal decrease of 3% in antibiotic consumption between 2015 and 2019. Further research is needed to understand the implications and long-term effects of the observed reductions on antibiotic use on antibiotic resistance in Canada.
Identifiants
pubmed: 34757115
pii: S1198-743X(21)00614-5
doi: 10.1016/j.cmi.2021.10.013
pmc: PMC8556063
pii:
doi:
Substances chimiques
Anti-Bacterial Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
426-432Informations de copyright
Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.
Références
Elife. 2018 Dec 18;7:
pubmed: 30560781
Infect Control Hosp Epidemiol. 2020 Feb;41(2):135-142
pubmed: 31755401
CMAJ. 2021 Feb 8;193(6):E200-E210
pubmed: 33558406
Eur J Clin Invest. 2008 Oct;38 Suppl 2:45-9
pubmed: 18826481
Clin Microbiol Infect. 2021 Feb 16;:
pubmed: 33601010
Clin Infect Dis. 2019 Jul 2;69(2):233-242
pubmed: 30339254
CMAJ Open. 2020 May 7;8(2):E360-E369
pubmed: 32381687
Clin Infect Dis. 2020 Jan 16;70(3):370-377
pubmed: 30882145
J Antimicrob Chemother. 2018 Feb 1;73(suppl_2):ii36-ii43
pubmed: 29490058
Pain Physician. 2018 May;21(3):219-228
pubmed: 29871366
Clin Infect Dis. 2021 Aug 2;73(3):e652-e660
pubmed: 33373435
Antimicrob Agents Chemother. 2013 May;57(5):2326-32
pubmed: 23478961
Pediatrics. 2019 May;143(5):
pubmed: 30962253
CMAJ. 2020 Nov 23;192(47):E1540-E1546
pubmed: 32998943
JAMA. 2016 May 3;315(17):1864-73
pubmed: 27139059
Open Forum Infect Dis. 2019 Oct 05;6(9):ofz393
pubmed: 31660415
CMAJ Open. 2018 Oct 31;6(4):E445-E452
pubmed: 30381321
Clin Infect Dis. 2019 Jun 18;69(1):182-188
pubmed: 30462185
Lancet Digit Health. 2021 Jun;3(6):e360-e370
pubmed: 34045002
PLoS One. 2019 Sep 26;14(9):e0223097
pubmed: 31557249
Emerg Infect Dis. 2006 Nov;12(11):1671-81
pubmed: 17283616