Abstract
Abstract
Background
The prescribing of antibiotics to treat COVID-19 patients has been observed to occur frequently, often without clear justification. This trend raises concerns that it may have exacerbated antimicrobial resistance (AMR). Despite longstanding concerns over AMR in Southeast Asian countries, data on this issue are notably lacking.
Objectives
To explore the impact of COVID-19 on antibiotic prescribing, bacterial infection prevalence and common resistant pathogens in COVID-19 inpatients.
Methods
We searched PubMed, EMBASE, Web of Science and ThaiJO (a Thai academic database) to identify studies conducted in ASEAN member countries and published between December 2019 and March 2023. Screening and data extraction were done by two independent reviewers, with results synthesized using random-effects meta-analyses and descriptive statistical analyses. This review was registered with PROSPERO (CRD42023454337).
Results
Of the 29 studies (19 750 confirmed COVID-19 cases) included for final analysis, the antibiotic prescribing rate was 62.0% (95%CI: 46.0%–76.0%) with a prescribing rate of 58.0% (21.0%–91.0%) in mild/moderate cases versus 91.0% (82.0%–98.0%) in severe/critical cases. Notably, 80.5% of antibiotics prescribed fall under the WHO AWaRe ‘Watch’ list, followed by ‘Access’ at 18.4% and ‘Reserve’ at 1.0%. The reported bacterial infection prevalence was 16.0% (7.0%–29.0%), with Acinetobacter baumannii being the most common resistant bacterium at 7.7%. Singapore was notable for its lower antibiotic prescribing rate of 17.0% and a lower bacterial infection rate of 10.0%.
Conclusions
High antibiotic prescribing rates, disproportionate to bacterial infections and varying practices for COVID-19 inpatients across countries highlight the urgent need for this region to collaborate to tackle and mitigate AMR.
Background
The prescribing of antibiotics to treat COVID-19 patients has been observed to occur frequently, often without clear justification. This trend raises concerns that it may have exacerbated antimicrobial resistance (AMR). Despite longstanding concerns over AMR in Southeast Asian countries, data on this issue are notably lacking.
Objectives
To explore the impact of COVID-19 on antibiotic prescribing, bacterial infection prevalence and common resistant pathogens in COVID-19 inpatients.
Methods
We searched PubMed, EMBASE, Web of Science and ThaiJO (a Thai academic database) to identify studies conducted in ASEAN member countries and published between December 2019 and March 2023. Screening and data extraction were done by two independent reviewers, with results synthesized using random-effects meta-analyses and descriptive statistical analyses. This review was registered with PROSPERO (CRD42023454337).
Results
Of the 29 studies (19 750 confirmed COVID-19 cases) included for final analysis, the antibiotic prescribing rate was 62.0% (95%CI: 46.0%–76.0%) with a prescribing rate of 58.0% (21.0%–91.0%) in mild/moderate cases versus 91.0% (82.0%–98.0%) in severe/critical cases. Notably, 80.5% of antibiotics prescribed fall under the WHO AWaRe ‘Watch’ list, followed by ‘Access’ at 18.4% and ‘Reserve’ at 1.0%. The reported bacterial infection prevalence was 16.0% (7.0%–29.0%), with Acinetobacter baumannii being the most common resistant bacterium at 7.7%. Singapore was notable for its lower antibiotic prescribing rate of 17.0% and a lower bacterial infection rate of 10.0%.
Conclusions
High antibiotic prescribing rates, disproportionate to bacterial infections and varying practices for COVID-19 inpatients across countries highlight the urgent need for this region to collaborate to tackle and mitigate AMR.
| Original language | English |
|---|---|
| Article number | dlae093 |
| Number of pages | 11 |
| Journal | JAC-Antimicrobial Resistance |
| Volume | 6 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - 11 Jun 2024 |
Bibliographical note
Publisher Copyright:© 2024 The Author(s). Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy.