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. 2022 Feb 2;17(2):e0263437.
doi: 10.1371/journal.pone.0263437. eCollection 2022.

Azithromycin consumption during the COVID-19 pandemic in Croatia, 2020

Nikolina Bogdanić  1 , Loris Močibob  1 , Toni Vidović  2 , Ana Soldo  2 , Josip Begovać  1   3
Affiliations

Azithromycin consumption during the COVID-19 pandemic in Croatia, 2020

Nikolina Bogdanić et al. PLoS One. .

Erratum in

Abstract

Background: During the initial phase of the COVID-19 pandemic, there was great enthusiasm for the use of azithromycin with or without hydroxychloroquine.

Objectives: We analyzed azithromycin consumption in Croatia in 2020 and compared this to the period 2017-2019.

Methods: Azithromycin consumption was evaluated using the IQVIA Adriatic d.o.o. database which collects data on azithromycin distribution from wholesale pharmacies to hospital and non-hospital pharmacies in Croatia. We analyzed data for the period from January 2017 to December 2020. Azithromycin distribution was measured as days of therapy (DOT) and reported as per 1000 inhabitants or per 1000 inhabitant-days.

Results: In the period 2017-2020, total azithromycin DOT in Croatia increased in 2017, 2018, 2019, and 2020 (1.76, 1.91, 1.91 and 2.01/1000 inhabitant-days, respectively). Non-hospital pharmacies received 2.18 times and hospital pharmacies 4.39 times more DOT units/1000 inhabitants of azithromycin in March 2020 compared to the average distribution rate in March 2017-2019. During the peak of the COVID-19 epidemic (November and December 2020) azithromycin distribution increased considerably in hospital (3.62 and 3.19 times, respectively) and non-hospital pharmacies (1.93 and 1.84 times, respectively) compared to the average consumption in the same months in 2017-2019.

Conclusions: Our data showed increased azithromycin distribution in the period 2017-2020 which indicates azithromycin overuse. Preliminary information on COVID-19 treatments with a desire to offer and try what is available even in the absence of strong scientific evidence may have influenced practices of antimicrobial prescriptions.

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Conflict of interest statement

This commercial affiliation does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1
Days of therapy (DOT) units of azithromycin dispensed per month to non-hospital (panel A) and hospital (panel B) pharmacies in Croatia from 2017 to 2020. Open bars are number of COVID-19 cases. A strict lockdown was in place from March 19th to April 27th, 2020.
Fig 2
Fig 2
The monthly distribution of azithromycin in 2020 compared to the average of 2017 to 2019 for non-hospital (panel A) and hospital (panel B) pharmacies in Croatia. DOT, days of therapy.
See this image and copyright information in PMC

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