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. 2022 Nov 3;11(11):1544.
doi: 10.3390/antibiotics11111544.

Impact of the COVID-19 Outbreak on the Antibiotic Use Patterns among a Rural Community Population in Eastern China

Bingbing Zhu  1 , Xinping Zhao  1 , Yurong Li  1 , Na Wang  1 , Helen Lambert  2 , Fei Yan  1 , Qingwu Jiang  1 , Chaowei Fu  1
Affiliations

Impact of the COVID-19 Outbreak on the Antibiotic Use Patterns among a Rural Community Population in Eastern China

Bingbing Zhu et al. Antibiotics (Basel). .

Abstract

There are growing concerns that the coronavirus disease of 2019 (COVID-19) pandemic may change antibiotic use patterns and accelerate antibiotic resistance, but evidence from the community level is lacking. This study aims to estimate the impact of the COVID-19 outbreak on the antibiotic use patterns among a community population in Eastern China. A self-administered medicine diary was used to collect information on antibiotic use from July 2019 to June 2021 among a rural community in Eastern China. We analyzed the changes in antibiotic use patterns over five months from August to December 2019 and the corresponding months in 2020. The risk of antibiotic use and its changes were measured with the incidence rate (IR) and relative risk (RR). In total, 1111 participants were eligible for the final analysis (440 in 2019 and 671 in 2020). After the COVID-19 outbreak, antibiotic use increased by 137% (5.43 per 100 person months in the 2019 vs. 12.89 per 100 person months in the 2020), and after the adjustment of covariates, the adjusted RR was 1.72 (95% CI: 1.10~2.34). It was higher among those who were women (RR = 2.62), aged 35−59 years old (RR = 2.72), non-farmers (RR = 2.75), had less than six years of education (RR = 2.61), had an annual household income over CNY 100,000 (USD 14,940) (RR = 2.60), and had no history of chronic diseases (RR = 2.61) (all p < 0.05). The proportion of cephalosporins consumed increased from 54.29% in 2019 to 64.92% in 2020 (p = 0.011). Among those aged 35 years and older, the proportion of antibiotics obtained from medical facilities increased, while the proportion obtained from retail pharmacies, homes, and other sources decreased (all p < 0.05). The COVID-19 outbreak changed antibiotic use patterns in this study population (Eastern China) significantly. More efforts to monitor and enhance antibiotic stewardship activities at the community level are needed in future.

Keywords: antibiotic use; community population; impact of the COVID-19 outbreak; rural China.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Figure 1
Figure 1
The proportion of different categories of antibiotics in medicine diaries among the study population in Eastern China, 2019–2020. (Data shown are unstandardized percentages. The proportion of cephalosporins are different between 2019 and 2020 (p = 0.011).).
Figure 2
Figure 2
Sources of antibiotics in medicine diaries among the study population in Eastern China, 2019–2020. (Data shown are unstandardized percentages. In total, the sources of antibiotics changed significantly after COVID-19 (p = 0.002)).
Figure 3
Figure 3
Reasons for antibiotic use in medicine diaries among the study population in Eastern China, 2019–2020. (Data shown are unstandardized percentages. In total, the sources of antibiotics changed significantly after COVID-19 (p = 0.005)).
See this image and copyright information in PMC

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