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. 2023 May 23;12(6):945.
doi: 10.3390/antibiotics12060945.

Impact of the COVID-19 Pandemic on Community Consumption of Antibiotics for Systemic Use and Resistance of Invasive Streptococcus pneumoniae in Slovenia

Tamara Kastrin  1 , Verica Mioč  1 , Aleksander Mahnič  2 , Milan Čižman  3 , Slovenian Meningitidis Study Group
Affiliations

Impact of the COVID-19 Pandemic on Community Consumption of Antibiotics for Systemic Use and Resistance of Invasive Streptococcus pneumoniae in Slovenia

Tamara Kastrin et al. Antibiotics (Basel). .

Abstract

The present study aims to investigate the impact of the COVID-19 pandemic on community antibiotic consumption and the resistance of invasive Streptococcus pneumoniae (2015-2022) to penicillin in Slovenia. During the pandemic in 2020 and 2021, the total use of antibiotics for systemic use decreased by 23.5% and 24.3%, expressed in defined daily doses per 1000 inhabitants per day (DID), while the use of penicillins, macrolides and broad-spectrum penicillins decreased by 30%, 20% and by 17.5%, respectively, and that of broad-spectrum macrolides fell by 17.1%. The incidence of invasive pneumococcal diseases (IPD) in Slovenia had a large decline during the pandemic. Decreased resistance to macrolides was significantly associated with decreased use of macrolides, while for penicillins the correlation could not be statistically confirmed. The proportion of PCV13 serotypes in IPD in Slovenia decreased after the introduction of the vaccine in the national programme, falling from 81.6% in 2015 to 45.5% in 2022. We noticed a decrease in the serotypes 1, 14, 9V, 7F, 4, 6A and an increase in the serotypes 3, 8, 22F, 11A, 23A and 15A. National interventions during the COVID-19 pandemic substantially decreased outpatients' antibiotic consumption, as well as incidence and resistance of invasive S. pneumoniae.

Keywords: S. pneumoniae; Slovenia; antibiotic; consumption; resistance; serotype.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Incidence of invasive Streptococcus pneumoniae in Slovenia, 2000–2022.
Figure 2
Figure 2
Correlations between the total use of antibiotics for systemic use (J01), penicillins (J01C), broad-spectrum penicillins (J01CR), macrolides (J01FA) and broad-spectrum macrolides (J01FA-FA1) expressed in DID and in RxIDs and the resistance of invasive strains of S. pneumoniae in Slovenia 2015–2022.
Figure 3
Figure 3
Yearly distribution of PCV13 and non-PCV13 serotypes among IPD in Slovenia, 2015 to 2022, * PCV10 introduced, ** PCV13 introduced.
Figure 4
Figure 4
Proportions of the most common serotypes of IPD in Slovenia in two periods, 2015–2019 and 2020–2022, * PCV13 serotype.
See this image and copyright information in PMC

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