e4627906bf9a62acca18a4111248d183 antibiotics-10-00132.pdf b4a42688cec4272b0b9628ec772b8dd5af01e45b antibiotics-10-00132.pdf 609703e4bc1a706955624d59323113aacef8d16229e3b792508d07586a7af3c1 antibiotics-10-00132.pdf Title: Evolution of Antimicrobial Consumption During the First Wave of COVID-19 Pandemic Subject: Background: The first wave of COVID-19 pandemic may have significantly impacted antimicrobial consumption in hospitals. The objective of this study was to assess the evolution of antimicrobial consumption during this period. Methods: A retrospective quasi-experimental before–after study was conducted in a Spanish tertiary care hospital. The study compared two periods: pre-pandemic, from January 2018 to February 2020, and during the COVID-19 pandemic from March to June 2020. Antimicrobial consumption was analyzed monthly as defined daily doses (DDD)/100 bed-days and overall hospital and ICU consumption were evaluated. Results: An increase in the hospital consumption was noticed. Although only ceftaroline achieved statistical significance (p = 0.014), a rise was observed in most of the studied antimicrobials. A clear temporal pattern was detected. While an increase in ceftriaxone and azithromycin was observed during March, an increment in the consumption of daptomycin, carbapenems, linezolid, ceftaroline, novel cephalosporin/-lactamase inhibitors or triazoles during April–May was noticed. In the ICU, these findings were more evident, namely ceftriaxone (p = 0.029), carbapenems (p = 0.002), daptomycin (p = 0.002), azithromycin (p = 0.030), and linezolid (p = 0.011) but followed a similar temporal pattern. Conclusion: An increase in the antimicrobial consumption during the first wave of COVID-19 pandemic was noticed, especially in the ICU. Availability of updated protocols and antimicrobial stewardship programs are essential to optimize these outcomes. Keywords: antimicrobial stewardship; COVID-19; defined daily doses (DDD); antimicrobial resistance; antibiotic consumption Author: Santiago Grau, Daniel Echeverria-Esnal, Silvia Gómez-Zorrilla, Maria Eugenia Navarrete-Rouco, Joan Ramon Masclans, Merce Espona, Maria Pilar Gracia-Arnillas, Xavier Duran, Merce Comas, Juan Pablo Horcajada and Olivia Ferrández Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Sat Feb 20 09:38:36 2021 CET ModDate: Sat Feb 20 09:43:34 2021 CET Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 11 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1450364 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- CNRZPM+VnURWPalladioL Type 1 Custom yes yes no 10 0 LWLIVD+EURM10 Type 1 Builtin yes yes no 15 0 TIYQTB+URWPalladioL-Ital Type 1 Custom yes yes no 19 0 CLFHSA+URWPalladioL-Bold Type 1 Custom yes yes no 24 0 OBYWLX+URWPalladioL-Roma Type 1 Custom yes yes no 28 0 ENXZUH+VnURWPalladioL-Bold Type 1 Custom yes yes no 32 0 YYFPCJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 41 0 MCBCCI+SourceSansRoman-Regular Type 1C Custom yes yes no 63 0 MCBCCM+SourceSansRoman.613wght Type 1C Custom yes yes no 67 0 MCBCCO+SourceSansRoman-Bold Type 1C Custom yes yes no 71 0 FNTSBS+PalatinoLinotype-Italic CID TrueType Identity-H yes yes yes 90 0 FNTSBS+PalatinoLinotype-Bold CID TrueType Identity-H yes yes yes 96 0 FNTSBS+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 102 0 BZSKCE+CMSY10 Type 1 Builtin yes yes no 127 0 FNTSBS+PalatinoLinotype-Bold CID TrueType Identity-H yes yes yes 133 0 FNTSBS+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 139 0 FNTSBS+PalatinoLinotype-Italic CID TrueType Identity-H yes yes yes 145 0 FNTSBS+PalatinoLinotype-Bold CID TrueType Identity-H yes yes yes 162 0 FNTSBS+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 168 0 FNTSBS+PalatinoLinotype-Italic CID TrueType Identity-H yes yes yes 174 0 FNTSBS+PalatinoLinotype-Italic CID TrueType Identity-H yes yes yes 192 0 FNTSBS+PalatinoLinotype-Bold CID TrueType Identity-H yes yes yes 198 0 FNTSBS+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 204 0 CRJHCU+PazoMath-Italic Type 1 Builtin yes yes no 219 0 RFLZJB+CMR10 Type 1 Builtin yes yes no 223 0 AWDAAW+VnURWPalladioL-Italic Type 1 Custom yes yes no 236 0 Jhove (Rel. 1.22.1, 2019-04-17) Date: 2023-05-26 02:28:36 CEST RepresentationInformation: antibiotics-10-00132.pdf ReportingModule: PDF-hul, Rel. 1.12.1 (2019-04-17) LastModified: 2022-12-14 18:22:09 CET Size: 1450364 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 358 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@44c8afef Item: Title: Results Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7b69c6ba Item: Title: Discussion Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@46daef40 Item: Title: Materials and Methods Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@12f41634 Children: Item: Title: Study Design and Hospital Setting Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@13c27452 Item: Title: Study Period and Study Population Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@262b2c86 Item: Title: Impact of the COVID-19 Pandemic Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@371a67ec Item: Title: Antimicrobial Consumption Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@5ed828d Item: Title: Statistical Analysis Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@50d0686 Item: Title: Conclusions Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7a3d45bd Item: Title: References Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1e7c7811 Info: Title: Evolution of Antimicrobial Consumption During the First Wave of COVID-19 Pandemic Author: Santiago Grau, Daniel Echeverria-Esnal, Silvia Gómez-Zorrilla, Maria Eugenia Navarrete-Rouco, Joan Ramon Masclans, Merce Espona, Maria Pilar Gracia-Arnillas, Xavier Duran, Merce Comas, Juan Pablo Horcajada and Olivia Ferrández Subject: Background: The first wave of COVID-19 pandemic may have significantly impacted antimicrobial consumption in hospitals. The objective of this study was to assess the evolution of antimicrobial consumption during this period. Methods: A retrospective quasi-experimental before after study was conducted in a Spanish tertiary care hospital. The study compared two periods: pre-pandemic, from January 2018 to February 2020, and during the COVID-19 pandemic from March to June 2020. Antimicrobial consumption was analyzed monthly as defined daily doses (DDD)/100 bed-days and overall hospital and ICU consumption were evaluated. Results: An increase in the hospital consumption was noticed. Although only ceftaroline achieved statistical significance (p = 0.014), a rise was observed in most of the studied antimicrobials. A clear temporal pattern was detected. While an increase in ceftriaxone and azithromycin was observed during March, an increment in the consumption of daptomycin, carbapenems, linezolid, ceftaroline, novel cephalosporin/-lactamase inhibitors or triazoles during April May was noticed. In the ICU, these findings were more evident, namely ceftriaxone (p = 0.029), carbapenems (p = 0.002), daptomycin (p = 0.002), azithromycin (p = 0.030), and linezolid (p = 0.011) but followed a similar temporal pattern. Conclusion: An increase in the antimicrobial consumption during the first wave of COVID-19 pandemic was noticed, especially in the ICU. Availability of updated protocols and antimicrobial stewardship programs are essential to optimize these outcomes. Keywords: antimicrobial stewardship; COVID-19; defined daily doses (DDD); antimicrobial resistance; antibiotic consumption Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Sat Feb 20 09:38:36 CET 2021 ModDate: Sat Feb 20 09:43:34 CET 2021 ID: 0xd12155d05eddb1c2d7455cb5c8f7bda5, 0xd12155d05eddb1c2d7455cb5c8f7bda5 Filters: FilterPipeline: FlateDecode Fonts: Type1: Font: BaseFont: ENXZUH+VnURWPalladioL-Bold FontSubset: true FirstChar: 161 LastChar: 226 FontDescriptor: FontName: ENXZUH+VnURWPalladioL-Bold Flags: Symbolic FontBBox: -152, -301, 1000, 935 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: TIYQTB+URWPalladioL-Ital FontSubset: true FirstChar: 3 LastChar: 151 FontDescriptor: FontName: TIYQTB+URWPalladioL-Ital Flags: Symbolic FontBBox: -170, -305, 1010, 941 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: CLFHSA+URWPalladioL-Bold FontSubset: true FirstChar: 3 LastChar: 122 FontDescriptor: FontName: CLFHSA+URWPalladioL-Bold Flags: Symbolic FontBBox: -152, -301, 1000, 935 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: CNRZPM+VnURWPalladioL FontSubset: true FirstChar: 129 LastChar: 243 FontDescriptor: FontName: CNRZPM+VnURWPalladioL Flags: Symbolic FontBBox: -166, -283, 1021, 943 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: CRJHCU+PazoMath-Italic FontSubset: true FirstChar: 98 LastChar: 98 FontDescriptor: FontName: CRJHCU+PazoMath-Italic Flags: Symbolic FontBBox: -70, -277, 902, 733 FontFile: true Font: BaseFont: OBYWLX+URWPalladioL-Roma FontSubset: true FirstChar: 2 LastChar: 246 FontDescriptor: FontName: OBYWLX+URWPalladioL-Roma Flags: Symbolic FontBBox: -166, -283, 1021, 943 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: AWDAAW+VnURWPalladioL-Italic FontSubset: true FirstChar: 160 LastChar: 160 FontDescriptor: FontName: AWDAAW+VnURWPalladioL-Italic Flags: Symbolic FontBBox: -170, -305, 1010, 941 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: LWLIVD+EURM10 FontSubset: true FirstChar: 12 LastChar: 12 FontDescriptor: FontName: LWLIVD+EURM10 Flags: Symbolic FontBBox: -32, -243, 1060, 720 FontFile: true Font: BaseFont: BZSKCE+CMSY10 FontSubset: true FirstChar: 0 LastChar: 3 FontDescriptor: FontName: BZSKCE+CMSY10 Flags: Symbolic FontBBox: -29, -960, 1116, 775 FontFile: true Font: BaseFont: RFLZJB+CMR10 FontSubset: true FirstChar: 43 LastChar: 61 FontDescriptor: FontName: RFLZJB+CMR10 Flags: Symbolic FontBBox: -40, -250, 1009, 750 FontFile: true Pages: Page: Sequence: 1 Annotations: Annotation: Subtype: Link Rect: 35, 759, 167, 795 Annotation: Subtype: Link Rect: 515, 759, 560, 795 Annotation: Subtype: Link Rect: 120, 662, 131, 675 Annotation: Subtype: Link Rect: 521, 662, 532, 675 Annotation: Subtype: Link Rect: 81, 334, 154, 343 Annotation: Subtype: Link Rect: 35, 323, 123, 331 Annotation: Subtype: Link Rect: 35, 162, 97, 184 Annotation: Subtype: Link Rect: 153, 89, 154, 98 Annotation: Subtype: Link Rect: 35, 77, 147, 86 Annotation: Subtype: Link Rect: 120, 17, 281, 28 Annotation: Subtype: Link Rect: 398, 17, 558, 28 Annotation: Subtype: Link Rect: 35, 446, 87, 465 Page: Sequence: 2 Annotations: Annotation: Subtype: Link Rect: 418, 737, 425, 746 ActionDest: 227 Annotation: Subtype: Link Rect: 428, 737, 435, 746 ActionDest: 227 Annotation: Subtype: Link Rect: 510, 724, 517, 733 ActionDest: 227 Annotation: Subtype: Link Rect: 377, 699, 384, 708 ActionDest: 227 Annotation: Subtype: Link Rect: 305, 649, 312, 658 ActionDest: 227 Annotation: Subtype: Link Rect: 418, 586, 425, 595 ActionDest: 230 Annotation: Subtype: Link Rect: 438, 573, 445, 582 ActionDest: 230 Annotation: Subtype: Link Rect: 276, 548, 283, 557 ActionDest: 230 Annotation: Subtype: Link Rect: 283, 548, 290, 557 ActionDest: 230 Annotation: Subtype: Link Rect: 213, 511, 220, 520 ActionDest: 230 Annotation: Subtype: Link Rect: 348, 473, 360, 482 ActionDest: 230 Annotation: Subtype: Link Rect: 319, 448, 331, 457 ActionDest: 230 Annotation: Subtype: Link Rect: 520, 410, 532, 419 ActionDest: 230 Annotation: Subtype: Link Rect: 535, 410, 547, 419 ActionDest: 230 Annotation: Subtype: Link Rect: 350, 385, 357, 394 ActionDest: 227 Annotation: Subtype: Link Rect: 357, 385, 369, 394 ActionDest: 230 Annotation: Subtype: Link Rect: 372, 385, 384, 394 ActionDest: 230 Annotation: Subtype: Link Rect: 552, 231, 559, 244 ActionDest: 83 Page: Sequence: 3 Page: Sequence: 4 Annotations: Annotation: Subtype: Link Rect: 200, 616, 207, 628 ActionDest: 157 Page: Sequence: 5 Annotations: Annotation: Subtype: Link Rect: 297, 150, 304, 162 ActionDest: 185 Page: Sequence: 6 Annotations: Annotation: Subtype: Link Rect: 364, 397, 376, 406 ActionDest: 230 Annotation: Subtype: Link Rect: 228, 385, 240, 394 ActionDest: 230 Annotation: Subtype: Link Rect: 243, 385, 254, 394 ActionDest: 230 Annotation: Subtype: Link Rect: 348, 385, 359, 394 ActionDest: 230 Annotation: Subtype: Link Rect: 360, 385, 372, 394 ActionDest: 230 Annotation: Subtype: Link Rect: 400, 347, 412, 356 ActionDest: 230 Annotation: Subtype: Link Rect: 384, 309, 396, 318 ActionDest: 230 Annotation: Subtype: Link Rect: 396, 309, 408, 318 ActionDest: 230 Annotation: Subtype: Link Rect: 304, 284, 316, 293 ActionDest: 230 Annotation: Subtype: Link Rect: 373, 272, 385, 281 ActionDest: 230 Annotation: Subtype: Link Rect: 543, 184, 555, 193 ActionDest: 230 Annotation: Subtype: Link Rect: 400, 171, 412, 180 ActionDest: 230 Annotation: Subtype: Link Rect: 248, 121, 260, 130 ActionDest: 230 Page: Sequence: 7 Annotations: Annotation: Subtype: Link Rect: 364, 735, 371, 744 ActionDest: 227 Annotation: Subtype: Link Rect: 218, 697, 230, 706 ActionDest: 230 Annotation: Subtype: Link Rect: 408, 572, 420, 581 ActionDest: 230 Annotation: Subtype: Link Rect: 290, 484, 302, 493 ActionDest: 230 Annotation: Subtype: Link Rect: 349, 459, 361, 468 ActionDest: 230 Annotation: Subtype: Link Rect: 317, 421, 329, 430 ActionDest: 230 Page: Sequence: 8 Annotations: Annotation: Subtype: Link Rect: 366, 694, 378, 703 ActionDest: 230 Annotation: Subtype: Link Rect: 249, 644, 261, 653 ActionDest: 230 Annotation: Subtype: Link Rect: 239, 543, 251, 553 ActionDest: 230 Annotation: Subtype: Link Rect: 285, 506, 292, 515 ActionDest: 227 Annotation: Subtype: Link Rect: 271, 242, 283, 251 ActionDest: 233 Annotation: Subtype: Link Rect: 284, 242, 295, 251 ActionDest: 233 Page: Sequence: 9 Annotations: Annotation: Subtype: Link Rect: 421, 507, 560, 518 Annotation: Subtype: Link Rect: 166, 496, 229, 506 Annotation: Subtype: Link Rect: 414, 252, 560, 263 Annotation: Subtype: Link Rect: 56, 241, 327, 252 Annotation: Subtype: Link Rect: 59, 173, 97, 183 Annotation: Subtype: Link Rect: 103, 173, 139, 183 Annotation: Subtype: Link Rect: 148, 137, 185, 148 Annotation: Subtype: Link Rect: 192, 137, 228, 148 Annotation: Subtype: Link Rect: 402, 103, 439, 114 Annotation: Subtype: Link Rect: 445, 103, 481, 114 Annotation: Subtype: Link Rect: 59, 58, 97, 68 Page: Sequence: 10 Annotations: Annotation: Subtype: Link Rect: 346, 721, 384, 732 Annotation: Subtype: Link Rect: 59, 676, 97, 686 Annotation: Subtype: Link Rect: 115, 652, 153, 663 Annotation: Subtype: Link Rect: 266, 617, 560, 628 Annotation: Subtype: Link Rect: 56, 606, 281, 617 Annotation: Subtype: Link Rect: 440, 594, 478, 605 Annotation: Subtype: Link Rect: 277, 583, 560, 594 Annotation: Subtype: Link Rect: 56, 571, 415, 582 Annotation: Subtype: Link Rect: 157, 548, 365, 559 Annotation: Subtype: Link Rect: 59, 526, 97, 536 Annotation: Subtype: Link Rect: 151, 492, 188, 502 Annotation: Subtype: Link Rect: 195, 492, 231, 502 Annotation: Subtype: Link Rect: 519, 468, 557, 479 Annotation: Subtype: Link Rect: 59, 457, 95, 467 Annotation: Subtype: Link Rect: 430, 445, 467, 456 Annotation: Subtype: Link Rect: 473, 445, 509, 456 Annotation: Subtype: Link Rect: 162, 423, 199, 433 Annotation: Subtype: Link Rect: 205, 423, 241, 433 Annotation: Subtype: Link Rect: 82, 388, 119, 398 Annotation: Subtype: Link Rect: 114, 354, 152, 364 Annotation: Subtype: Link Rect: 285, 318, 323, 329 Annotation: Subtype: Link Rect: 201, 284, 238, 295 Annotation: Subtype: Link Rect: 121, 249, 159, 260 Annotation: Subtype: Link Rect: 269, 215, 307, 226 Annotation: Subtype: Link Rect: 352, 192, 390, 203 Annotation: Subtype: Link Rect: 520, 169, 557, 180 Annotation: Subtype: Link Rect: 59, 158, 95, 168 Annotation: Subtype: Link Rect: 460, 134, 498, 145 Annotation: Subtype: Link Rect: 504, 134, 540, 145 Annotation: Subtype: Link Rect: 208, 100, 246, 111 Annotation: Subtype: Link Rect: 125, 66, 163, 76 Annotation: Subtype: Link Rect: 169, 66, 205, 76 Page: Sequence: 11 Annotations: Annotation: Subtype: Link Rect: 151, 686, 408, 697 Checksum: bf7c47f1 Type: CRC32 Checksum: e4627906bf9a62acca18a4111248d183 Type: MD5 Checksum: b4a42688cec4272b0b9628ec772b8dd5af01e45b Type: SHA-1