Mary Wilson
Well-known member
Published: 10 March 2021
Katryna A Gouin, MPH, Stephen Creasy, PharmD, Mary Beckerson, MS, Martha Wdowicki, PharmD, Lauri A Hicks, DO, Jennifer N Lind, PharmD, MPH, Andrew I Geller, MD, Daniel S Budnitz, MD, MPH, Sarah Kabbani, MD, MSc
Clinical Infectious Diseases, ciab225, https://doi.org/10.1093/cid/ciab225
Abstract
Background. Trends in prescribing for nursing home (NH) residents, which may have been influenced by the COVID-19 pandemic, have not been characterized.
Methods. Long-term care pharmacy data from 1,944 U.S. NHs were used to evaluate trends in prescribing of antibiotics and drugs that were investigated for COVID-19 treatment, including hydroxychloroquine, famotidine, and dexamethasone. To account for seasonal variability in antibiotic prescribing and decreased NH occupancy during the pandemic, monthly prevalence of residents with a prescription dispensed per 1,000 residents serviced was calculated from January ? October and compared as relative percent change from 2019 to 2020.
Results. In April 2020, prescribing was significantly higher in NHs for drugs investigated for COVID-19 treatment than 2019; including hydroxychloroquine (+563%, 95% confidence interval (CI) 5.87, 7.48) and azithromycin (+150%, 95% CI 2.37, 2.63). Ceftriaxone prescribing also increased (+43%, 95% CI 1.34, 1.54). Prescribing of dexamethasone was 36% lower in April (95% CI 0.55, 0.73) and 303% higher in July (95% CI 3.66, 4.45). Although azithromycin and ceftriaxone prescribing increased, total antibiotic prescribing among residents was lower from May (-5%, 95% CI 0.94, 0.97) through October (-4%, 95% CI 0.94, 0.97) in 2020 compared to 2019.
Conclusions. During the pandemic, large numbers of residents were prescribed drugs investigated for COVID-19 treatment, and an increase in prescribing of antibiotics commonly used for respiratory infections was observed. Prescribing of these drugs may increase the risk of adverse events, without providing clear benefits. Surveillance of NH prescribing practices is critical to evaluate concordance with guideline-recommended therapy and improve resident safety.
This content is only available as a PDF.
https://watermark.silverchair.com/c...8baGI914hMIhgF9v_tHWSXseTOGhyiqkNWtTjE2y-iWMQ
https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciab225/6167836#.YEkLiamWJLQ.twitter
Katryna A Gouin, MPH, Stephen Creasy, PharmD, Mary Beckerson, MS, Martha Wdowicki, PharmD, Lauri A Hicks, DO, Jennifer N Lind, PharmD, MPH, Andrew I Geller, MD, Daniel S Budnitz, MD, MPH, Sarah Kabbani, MD, MSc
Clinical Infectious Diseases, ciab225, https://doi.org/10.1093/cid/ciab225
Abstract
Background. Trends in prescribing for nursing home (NH) residents, which may have been influenced by the COVID-19 pandemic, have not been characterized.
Methods. Long-term care pharmacy data from 1,944 U.S. NHs were used to evaluate trends in prescribing of antibiotics and drugs that were investigated for COVID-19 treatment, including hydroxychloroquine, famotidine, and dexamethasone. To account for seasonal variability in antibiotic prescribing and decreased NH occupancy during the pandemic, monthly prevalence of residents with a prescription dispensed per 1,000 residents serviced was calculated from January ? October and compared as relative percent change from 2019 to 2020.
Results. In April 2020, prescribing was significantly higher in NHs for drugs investigated for COVID-19 treatment than 2019; including hydroxychloroquine (+563%, 95% confidence interval (CI) 5.87, 7.48) and azithromycin (+150%, 95% CI 2.37, 2.63). Ceftriaxone prescribing also increased (+43%, 95% CI 1.34, 1.54). Prescribing of dexamethasone was 36% lower in April (95% CI 0.55, 0.73) and 303% higher in July (95% CI 3.66, 4.45). Although azithromycin and ceftriaxone prescribing increased, total antibiotic prescribing among residents was lower from May (-5%, 95% CI 0.94, 0.97) through October (-4%, 95% CI 0.94, 0.97) in 2020 compared to 2019.
Conclusions. During the pandemic, large numbers of residents were prescribed drugs investigated for COVID-19 treatment, and an increase in prescribing of antibiotics commonly used for respiratory infections was observed. Prescribing of these drugs may increase the risk of adverse events, without providing clear benefits. Surveillance of NH prescribing practices is critical to evaluate concordance with guideline-recommended therapy and improve resident safety.
This content is only available as a PDF.
https://watermark.silverchair.com/c...8baGI914hMIhgF9v_tHWSXseTOGhyiqkNWtTjE2y-iWMQ
https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciab225/6167836#.YEkLiamWJLQ.twitter