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. 2021 Aug 4;10(8):943.
doi: 10.3390/antibiotics10080943.

Antimicrobial Consumption among 66 Acute Care Hospitals in Catalonia: Impact of the COVID-19 Pandemic

Santiago Grau  1   2   3 , Sergi Hernández  4 , Daniel Echeverría-Esnal  1   2 , Alexander Almendral  4 , Ricard Ferrer  5 , Enric Limón  4 , Juan Pablo Horcajada  2   6   7 ; Catalan Infection Control and Antimicrobial Stewardship Program (VINCat-PROA)
Collaborators, Affiliations

Antimicrobial Consumption among 66 Acute Care Hospitals in Catalonia: Impact of the COVID-19 Pandemic

Santiago Grau et al. Antibiotics (Basel). .

Abstract

Background: Antimicrobials have been widely used during the COVID-19 pandemic. This study aimed to analyze the impact of the COVID-19 pandemic on the antimicrobial consumption of 66 hospitals in Catalonia.

Methods: Adult antibacterial and antimycotic consumption was calculated as defined daily doses (DDD)/100 bed-days and DDD/100 discharges. Firstly, overall and ICU consumption in 2019 and 2020 were compared. Secondly, observed ICU 2020 consumptions were compared with non-COVID-19 2020 estimated consumptions (based on the trend from 2008-2019).

Results: Overall, antibacterial consumption increased by 2.31% and 4.15% DDD/100 bed-days and DDD/100 discharges, respectively. Azithromycin (105.4% and 109.08% DDD/100 bed-days and DDD/100 discharges, respectively) and ceftriaxone (25.72% and 27.97% DDD/100 bed-days and DDD/100 discharges, respectively) mainly accounted for this finding. Likewise, antifungal consumption increased by 10.25% DDD/100 bed-days and 12.22% DDD/100 discharges, mainly due to echinocandins or amphotericin B. ICU antibacterial and antimycotic consumption decreased by 1.28% and 4.35% DDD/100 bed-days, respectively. On the contrary, antibacterial and antifungal use, expressed in DDD/100 discharges, increased by 23.42% and 19.58%. Azithromycin (275.09%), ceftriaxone (55.11%), cefepime (106.35%), vancomycin (29.81%), linezolid (31.28%), amphotericin B (87.98%), and voriconazole (96.17%) use changed the most. Observed consumption of amphotericin B, azithromycin, caspofungin, ceftriaxone, vancomycin, and voriconazole were higher than estimated values.

Conclusions: The consumption indicators for most antimicrobials deviated from the expected trend pattern. A worrisome increase in antibacterial and antifungal consumption was observed in ICUs in Catalonia.

Keywords: COVID-19; antibiotics; antifungals; antimicrobial consumption; defined daily doses.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Evolution of overall and intensive care unit (ICU) bed-days and discharges 2008–2020.
Figure 2
Figure 2
Evolution of antibiotic and antimycotic consumption in intensive care unit (ICU) services between 2008 and 2020, expressed in DDD/100 discharges. Non-COVID-19 period was considered from 2008 to 2019. DDD: Defined daily doses. Black circles: Antimicrobial consumption data for every year. Blue line: Antimicrobial consumption trend based on data from 2008 to 2019, and projected until 2020. Red triangle: Observed 2020 consumption.
See this image and copyright information in PMC

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