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Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
Published on: August 30, 2018
COVID-19: An Emerging Threat to Antibiotic Stewardship in the Emergency Department
Michael S Pulia1, Ian Wolf2, Lucas T Schulz3
1University of Wisconsin Madison, School of Medicine and Public Health, Department of Emergency Medicine, Madison, Wisconsin.
Abstract:
While current research efforts focus primarily on identifying patient level interventions that mitigate the direct impact of COVID-19, it is important to consider the collateral effects of COVID-19 on antimicrobial resistance. Early reports suggest high rates of antibiotic utilization in COVID-19 patients despite their lack of direct activity against viral pathogens. The ongoing pandemic is exacerbating known barriers to optimal antibiotic stewardship in the ED, representing an additional direct threat to patient safety and public health. There is an urgent need for research analyzing overall and COVID-19 specific antibiotic prescribing trends in the ED. Optimizing ED stewardship during COVID-19 will likely require a combination of traditional stewardship approaches (e.g. academic detailing, provider education, care pathways) and effective implementation of host response biomarkers and rapid COVID-19 diagnostics. Antibiotic stewardship interventions with demonstrated efficacy in mitigating the impact of COVID-19 on ED prescribing should be widely disseminated and inform the ongoing pandemic response.
Insights
The COVID-19 pandemic has increased antibiotic use in emergency departments, worsening antimicrobial resistance. New strategies combining traditional stewardship with diagnostics are urgently needed to optimize antibiotic prescribing.
Area of Science:
- Infectious Diseases
- Public Health
- Health Services Research
Background:
- COVID-19 pandemic has led to increased antibiotic prescribing in emergency departments (EDs).
- Antibiotics are often used in viral infections like COVID-19 despite lacking direct efficacy.
- This trend exacerbates antimicrobial resistance (AMR) and poses a threat to public health.
Discussion:
- The pandemic intensifies existing challenges in antibiotic stewardship within ED settings.
- High rates of antibiotic use in COVID-19 patients highlight a critical need for improved prescribing practices.
- Urgent research is required to analyze antibiotic prescribing trends during the COVID-19 pandemic.
Key Insights:
- COVID-19's collateral impact on antimicrobial resistance is a significant concern.
- Optimizing ED antibiotic stewardship requires integrating traditional methods with novel approaches.
- Host response biomarkers and rapid diagnostics are crucial for informed prescribing decisions.
Outlook:
- Dissemination of effective antibiotic stewardship interventions is vital for pandemic response.
- Future strategies must address both direct COVID-19 impacts and indirect effects on AMR.
- Sustained focus on antibiotic stewardship is essential for patient safety and combating AMR.
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