Shiloh
Editor, Senior Moderator
Source: https://www.cidrap.umn.edu/news-perspective/2021/11/stewardship-resistance-scan-nov-01-2021
Stewardship / Resistance Scan for Nov 01, 2021
Pandemic antibiotic Rx drop in Canada; Unnecessary antibiotics for RSV
Filed Under:
Respiratory Syncytial Virus (RSV); Antimicrobial Stewardship
Canadian studies find pandemic-related drops in antibiotic prescribing
Antibiotic prescribing during the early COVID-19 months in Canada dropped sharply, according to two new studies, one that looked at retail pharmacy trends across the country and one that focused on outpatient prescribing patterns in Ontario.
In the first study, published in Clinical Microbiology and Infection, researchers examined antibiotic dispensing through retail pharmacies across the country from Nov 2014 to Oct 2020. They found that, during Canada's first 8 months of COVID-19 activity, the overall dispensing levels dropped by 26.5%, and the drop was even sharper for children. For comparison, the decline in the years before the pandemic—from 2015 to 2019—was just 3.0%.
Prescribing rates for antibiotics targeting respiratory infections declined more sharply than those targeting urinary tract and skin and other soft-tissue infections. The team said similar findings have been reported by the United States and United Kingdom and that decreased access to prescribers and public health measures during the early part of the pandemic that reduced communicable disease levels may have played roles.
Oct 29 Clin Microbiol Infect abstract
In the second study, researchers evaluated data from an antibiotic prescribing database to gauge trends in Ontario from January 2017 to December 2020, designating March to December of 2020 as the COVID-19 period.
They found a 31.2% drop in antibiotic prescriptions during the pandemic months. Their deeper look at the data revealed that the reduction in prescribing was driven more by fewer doctor's visits for respiratory than by less prescribing for respiratory indications.
Oct 30 Open Forum Infect Dis abstract
Israeli study reveals frequent antibiotic use in kids with RSV
Roughly a third of children hospitalized with respiratory syncytial virus (RSV) at a hospital in Israel over a 10-year period received unnecessary antibiotics, researchers reported last week in the Journal of Global Antimicrobial Resistance.
Among 1,227 children hospitalized at Hillel Yaffe Medical Center from 2008 through 2018 for RSV-bronchiolitis, which is a common cause of respiratory infections in Israeli children, 335 (27.3%) received unnecessary antibiotic treatment. But when they examined only children ascertained not to have a bacterial co-infection, unnecessary antibiotic treatment climbed to 33.4%. Among patients who had no bacterial cultures drawn, 19% received antibiotics.
Using a logistic regression model, the researchers identified several variables associated with unnecessary antibiotics. They included drawing of any bacterial culture (blood culture, urine culture, cerebrospinal culture), prior emergency room visit, lower oxygen saturation, higher body temperature, and abnormally rapid breathing. Girls and older children were also more likely to receive unnecessary antibiotics.
"The findings of this study indicate that the high rates of unnecessary antibiotic therapy in RSV-bronchiolitis patients may be largely due to the physicians' perception of disease severity," the authors wrote. "A better balance between prescribing and withholding antibiotics must be achieved to mitigate future rates of antibiotic resistance."
Oct 28 J Glob Antimicrob Resist study
Stewardship / Resistance Scan for Nov 01, 2021
Pandemic antibiotic Rx drop in Canada; Unnecessary antibiotics for RSV
Filed Under:
Respiratory Syncytial Virus (RSV); Antimicrobial Stewardship
Canadian studies find pandemic-related drops in antibiotic prescribing
Antibiotic prescribing during the early COVID-19 months in Canada dropped sharply, according to two new studies, one that looked at retail pharmacy trends across the country and one that focused on outpatient prescribing patterns in Ontario.
In the first study, published in Clinical Microbiology and Infection, researchers examined antibiotic dispensing through retail pharmacies across the country from Nov 2014 to Oct 2020. They found that, during Canada's first 8 months of COVID-19 activity, the overall dispensing levels dropped by 26.5%, and the drop was even sharper for children. For comparison, the decline in the years before the pandemic—from 2015 to 2019—was just 3.0%.
Prescribing rates for antibiotics targeting respiratory infections declined more sharply than those targeting urinary tract and skin and other soft-tissue infections. The team said similar findings have been reported by the United States and United Kingdom and that decreased access to prescribers and public health measures during the early part of the pandemic that reduced communicable disease levels may have played roles.
Oct 29 Clin Microbiol Infect abstract
In the second study, researchers evaluated data from an antibiotic prescribing database to gauge trends in Ontario from January 2017 to December 2020, designating March to December of 2020 as the COVID-19 period.
They found a 31.2% drop in antibiotic prescriptions during the pandemic months. Their deeper look at the data revealed that the reduction in prescribing was driven more by fewer doctor's visits for respiratory than by less prescribing for respiratory indications.
Oct 30 Open Forum Infect Dis abstract
Israeli study reveals frequent antibiotic use in kids with RSV
Roughly a third of children hospitalized with respiratory syncytial virus (RSV) at a hospital in Israel over a 10-year period received unnecessary antibiotics, researchers reported last week in the Journal of Global Antimicrobial Resistance.
Among 1,227 children hospitalized at Hillel Yaffe Medical Center from 2008 through 2018 for RSV-bronchiolitis, which is a common cause of respiratory infections in Israeli children, 335 (27.3%) received unnecessary antibiotic treatment. But when they examined only children ascertained not to have a bacterial co-infection, unnecessary antibiotic treatment climbed to 33.4%. Among patients who had no bacterial cultures drawn, 19% received antibiotics.
Using a logistic regression model, the researchers identified several variables associated with unnecessary antibiotics. They included drawing of any bacterial culture (blood culture, urine culture, cerebrospinal culture), prior emergency room visit, lower oxygen saturation, higher body temperature, and abnormally rapid breathing. Girls and older children were also more likely to receive unnecessary antibiotics.
"The findings of this study indicate that the high rates of unnecessary antibiotic therapy in RSV-bronchiolitis patients may be largely due to the physicians' perception of disease severity," the authors wrote. "A better balance between prescribing and withholding antibiotics must be achieved to mitigate future rates of antibiotic resistance."
Oct 28 J Glob Antimicrob Resist study