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Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
Published on: August 30, 2018
How did the COVID-19 pandemic affect antibiotic consumption within humanitarian emergencies? Results from five
Tuba Yavuz1, Kate Clezy2, Kristina Skender2
1Trinity Centre for Global Health, Trinity College Dublin, Dublin, Ireland.
Introduction:
Both high- and low-income countries reported increased antibiotic consumption among COVID-19 patients during the first months of the pandemic. To date, however, no studies have examined changes in antibiotic consumption during the COVID-19 pandemic within humanitarian emergency contexts.
Method:
Data was collected by Médecins Sans Frontières (MSF) for the years 2018-2021 across the following humanitarian settings: Afghanistan (Lashkar Gah), Bangladesh (Kutupalong), the Democratic Republic of Congo (Mweso and Baraka), and South Sudan (Bentiu). Inpatient and outpatient antibiotic consumption was calculated as Daily Defined Dose (DDD) per 1000 inhabitants per day, as per the World Health Organisation's (WHO) Collaborating Centre for Drug Statistics Methodology. Interrupted time series (ITS) analysis, using an autoregressive integrated moving average (ARIMA) model was used to analyse retrospective monthly antibiotic consumption. The impact of COVID-19 pandemic was evaluated as total antibiotic consumption and according to WHO Access, Watch, Reserve (AWaRe) group classifications within each humanitarian setting.
Results:
The COVID-19 pandemic had no statistically significant impact on total antibiotic consumption in South Sudan (Bentiu) and Bangladesh (Kutupalong). Similarly, the pandemic had no impact on total antibiotic consumption in DR Congo (Baraka), despite an initial 0.27% (estimate=.274, p-value=0.006) increase in March 2020 driven by Access group antibiotics. Meanwhile, total antibiotic consumption in DR Congo (Mweso) and Afghanistan (Lashkar Gah) declined by 0.74% (estimate = -.744, p = 0.003) and 0.26% (estimate = -.26, p < 0.001), respectively with the COVID-19 pandemic.
Conclusion:
Further studies are required to investigate what may have contributed to these results.
Insights
The COVID-19 pandemic did not significantly alter overall antibiotic consumption in humanitarian settings in South Sudan and Bangladesh. However, antibiotic use decreased in Afghanistan and the Democratic Republic of Congo (DRC) during the pandemic.
Area of Science:
- Global Health
- Infectious Disease Epidemiology
- Antimicrobial Stewardship
Background:
- Global antibiotic consumption increased during the COVID-19 pandemic, particularly in high- and low-income nations.
- No prior studies have assessed antibiotic consumption changes in humanitarian emergency contexts during the pandemic.
Purpose of the Study:
- To analyze the impact of the COVID-19 pandemic on antibiotic consumption within humanitarian emergency settings.
- To evaluate changes in antibiotic use across different World Health Organization (WHO) Access, Watch, Reserve (AWaRe) groups.
Main Methods:
- Retrospective analysis of monthly antibiotic consumption data (2018-2021) from Médecins Sans Frontières (MSF) in Afghanistan, Bangladesh, DR Congo, and South Sudan.
- Antibiotic consumption calculated as Daily Defined Dose (DDD) per 1000 inhabitants per day.
- Interrupted time series (ITS) analysis using autoregressive integrated moving average (ARIMA) models to assess pandemic impact.
Main Results:
- The COVID-19 pandemic showed no statistically significant impact on total antibiotic consumption in South Sudan (Bentiu) and Bangladesh (Kutupalong).
- In DR Congo (Baraka), total antibiotic consumption remained unaffected, despite a minor initial increase in Access group antibiotics.
- Total antibiotic consumption declined in DR Congo (Mweso) and Afghanistan (Lashkar Gah) during the pandemic.
Conclusions:
- The COVID-19 pandemic's impact on antibiotic consumption varied across humanitarian settings.
- Further research is needed to understand the factors influencing these observed trends in antibiotic use.
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