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Antibiotics Use in Hospitalised COVID-19 Patients in a Tertiary Care Centre: A Descriptive Cross-sectional Study
Bibechan Thapa1, Samyam Bickram Pathak2, Nisha Jha3
1Department of Emergency Medicine, Kirtipur Hospital, Kirtipur, Kathmandu, Nepal.
Insights
Antibiotic use was highly prevalent (98.11%) among hospitalized COVID-19 patients in Nepal, with most receiving multiple antibiotics. This highlights a critical issue in antimicrobial stewardship during the pandemic.
Area of Science:
- Medical Research
- Infectious Diseases
- Public Health
Background:
- Antimicrobial resistance (AMR) is a significant global health challenge, largely driven by widespread and inappropriate antibiotic use.
- Bacterial co-infections in COVID-19 patients often necessitate antibiotic treatment, complicating pandemic management and exacerbating AMR.
- The COVID-19 pandemic has negatively impacted antibiotic stewardship globally, leading to increased antibiotic consumption.
Purpose of the Study:
- To determine the prevalence of antibiotic use among hospitalized COVID-19 patients in a tertiary care center in Nepal.
- To address the limited existing research on antibiotic utilization in COVID-19 patients within the Nepalese context.
Main Methods:
- A descriptive cross-sectional study was conducted from April to June 2021.
- Data were collected from the medical records of 106 hospitalized COVID-19 patients.
- Convenience sampling was employed, and point estimates with 95% Confidence Intervals were calculated.
Main Results:
- The prevalence of antibiotic use among hospitalized COVID-19 patients was 98.11% (104 out of 106 patients).
- A significant majority, 71.15% (74 patients), received multiple antibiotics.
- Cephalosporins (81.73%) and macrolides (54.81%) were the most commonly prescribed antibiotic classes.
Conclusions:
- Antibiotic use was exceptionally high among hospitalized COVID-19 patients in this Nepalese tertiary care center.
- The observed prevalence of antibiotic use is higher than in comparable studies, indicating potential issues with antibiotic stewardship.
- Further investigation into the drivers of high antibiotic consumption in this population is warranted to combat antimicrobial resistance.
Introduction:
Antimicrobial resistance is a global health problem. The widespread and improper antibiotics use is the leading cause of antimicrobial resistance. Bacterial co-infection in COVID-19 patients is the basis for the use of antibiotics in the management of COVID-19. COVID-19 pandemic has seriously impacted antibiotic stewardship and increased the global usage of antibiotics, worsening the antimicrobial resistance problem. The use of antibiotics among COVID-19 patients is high but there are limited studies in the context of Nepal. This study aimed to find out the prevalence of antibiotic use among hospitalised COVID-19 patients in a tertiary care centre.
Methods:
A descriptive cross-sectional study was conducted on hospitalised COVID-19 patients from April 2021 to June 2021 in a tertiary care centre. Ethical approval was taken from the Institutional Review Committee (Reference number: 2078/79/05). The hospital data were collected in the proforma by reviewing the patient's medical records during the study period of 2 months. Convenience sampling was used. Point estimate and 95% Confidence Interval were calculated.
Results:
Among 106 hospitalised COVID-19 patients, the prevalence of antibiotic use was 104 (98.11%) (95.52-100, 95% Confidence Interval). About 74 (71.15%) of patients received multiple antibiotics. The most common classes of antibiotics used were cephalosporins, seen in 85 (81.73%) and macrolides, seen in 57 (54.81%) patients.
Conclusions:
The prevalence of antibiotic use among hospitalised COVID-19 patients was found to be higher when compared to other studies conducted in similar settings.
Keywords:
antibiotics; bacterial infection; co-infection; COVID-19.
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