4CPS-246 Coronavirus first wave effect on antibiotic consumption and antimicrobial resistance

Autor: E Palencia Herrejon, EA Álvaro Alonso, E Izquierdo García, B Sánchez Artola, I. Escobar Rodríguez, S Salso Ortiz, A Such Díaz, E Aznar Cano, S Esteban Casado, A Lázaro Cebas, P Tejedor Prado
Rok vydání: 2021
Předmět:
Zdroj: Section 4: Clinical pharmacy services.
DOI: 10.1136/ejhpharm-2021-eahpconf.78
Popis: Background and importance In the absence of evidence about the incidence of bacterial co-infection, antibiotic treatment was widely prescribed to prevent this potential complication Increasing antibiotic consumption could have exerted an ecological pressure on microorganisms with potential clinical implications that need to be examined Aim and objectives The aim of this study was to analyse antibiotic consumption and antimicrobial resistant microorganism isolates during the peak incidence of the COVID-19 first wave at our hospital Material and methods An observational, descriptive, cross sectional study was carried out Antibiotic consumption data for March and April 2020 and 2019 were analysed Defined daily dose (DDD) per 100 bed days was used as the consumption indicator and changes were expressed in absolute and percentage terms Isolates of Enterobacteriaceae (Escherichia coli and Klebsiella pneumoniae) were examined for March and April 2020 and compared with the average over 2019 Extended spectrum beta-lactamase (ESBL) producing Enterobacteriaceae were expressed in relative terms over their total isolates Results For the period under study, antibiotic consumption increased from 79 94 to 141 10 DDD/100 bed days in 2020, which was an increase of 77% Macrolides and cephalosporins were among the groups of antibiotics with the highest consumption, representing 37% (52 79 DDD/100 bed days) and 32% (45 41 DDD/100 bed days) of total consumption, respectively, and almost 70% jointly Additionally, ceftriaxone and azithromycin showed an increase in DDD/100 bed days of 4 5× (8 91 vs 39 97) and 27 4× (1 89 vs 51 90) with respect to the same period in 2019 The share of ESBL producing Escherichia coli was 12% (13/111 isolates) and 23% (20/87 isolates) in March and April 2020 compared with an average of 11% (273/2494 isolates) in 2019 ESBL producing Klebsiella pneumoniae was 23% (8/ 35 isolates) and 57% (25/44 isolates) in March and April 2020 versus 24% (153/642 isolates) on average in 2019 Conclusion and relevance During the study period, antibiotic consumption increased markedly The increasing use of third generation cephalosporins, which have no effect on ESBL producing Enterobacteriaceae, may have contributed to the observed changes in the bacterial ecology in our hospital As the incidence of bacterial co-infection on admission was reported to be lower than 5% and the increase in antibiotic consumption translated into selection of antibiotic resistant bacteria, it is important to properly assess antibiotic treatment for each particular case in future outbreaks of SARS-CoV-2 infections
Databáze: OpenAIRE