[Antimicrobial stewardship program during the COVID-19 pandemic]

Area of Science:

• Infectious Diseases
• Public Health
• Clinical Pharmacy

Background:

• High rates of empiric antibiotic use (70-90%) observed in COVID-19 patients, despite low bacterial coinfection rates.
• Need for strategies to optimize antibiotic prescribing in hospitalized COVID-19 patients.

Purpose of the Study:

• To evaluate the impact of an antimicrobial stewardship program (ASP) on antibiotic use and outcomes in COVID-19 patients.
• Assess changes in antibiotic prescribing patterns, treatment adequacy, and antimicrobial consumption.

Main Methods:

• Interrupted time series design.
• Analysis of antibiotic use, adequacy, and consumption in 101 adult COVID-19 patients before and after ASP implementation (June 2020).
• Data collected over four periods: pre-ASP, and three post-ASP periods (August 2020, October 2020, June 2021).

Main Results:

• Significant reduction in overall antibiotic use (61% to 8.1%) and macrolid combination therapy (17.3% to 1.4%).
• Increase in adequate antibiotic use (37.5% to 66.6%).
• Substantial decrease in antimicrobial consumption (347.9 to 43.6 DOT/1000 patient-days).
• No significant difference in intensive care unit transfer or mortality rates.

Conclusions:

• COVID-19 ASP implementation effectively reduced antimicrobial consumption and optimized antibiotic indications.
• The stewardship program demonstrated a positive impact on antibiotic prescribing practices without adversely affecting patient morbidity or mortality.