Long-term impact of COVID-19 pandemic on antibiotic use in primary care: lessons to optimize antimicrobial use

ABSTRACT

Background

Lockdowns due to the COVID-19 pandemic was associated with changes in the pattern of use of antimicrobials, but persistence of changes after lockdowns has not been described. The objective was to describe the number of patients with dispensed antibiotic treatment and consumption of antibiotics in outpatients from primary care in Catalonia 18 months after the end of the emergency period.

Research design and methods

Data for the COVID-19 pandemic period was obtained from March 2020 to December 2021. Four high transmission rate (Rt > 100) periods were established. To compare data, a simple Bayesian structural time series model was used.

Results

The observed number of patients with dispensed antibiotics decreased respect to the estimated, especially during the four high transmission rate periods: April–May 2020 (lockdown period) (−42.57% and −42.68%); December 2020-February 2021 (−41.65%, −49.97% and −43.64%); October 2021 (−16.23%), and December 2021 (−20.16%). Overall antibiotic consumption was reduced by 23.37% (p = 0.002). These differences were mainly observed in those ≤ 15 years.

Conclusions

We describe the reduction in the number of patients with dispensed antibiotics and antibiotic consumption after the COVID-19 lockdown persisted in a period of recovery of healthcare accessibility. This information may help to improve antimicrobial use at the primary care level.

KEYWORDS:

• Antibiotic consumption
• COVID-19
• defined daily doses
• primary care
• azithromycin

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Ethics

All investigators ensure that the planning, conduct, and reporting of human research are in accordance with the Helsinki Declaration as revised in 2013.

Data availability statement

Data is available upon request. This work is not a clinical trial so information concerning this type of study is not included.

Author contribution

Conception and design: Thais de Pando, Santiago Grau, Sergi Hernandez, Daniel Echeverria-Esnal, Enric Limon, Caridad Pontes; Analysis: Alexander Almendra, Sergi Hernandez; Interpretation of the data: Thais de Pando, Santiago Grau, Sergi Hernandez, Daniel Echeverria-Esnal, Enric Limon, Caridad Pontes; Drafting of the paper: Thais de Pando, Santiago Grau, Daniel Echeverría-Esnal; Final approval: All authors. We confirm that all authors have substantially contributed to the conception and design of the review article and interpreting the relevant literature and have been involved in writing the review article or revised it for intellectual content.

Additional information

Funding

This paper received no funding.