b712b78b3583786b8a87f498b9c4e27d pmc_34438993.pdf 40aeb88b58f000c7928a39a3e9bf74286cb131f4 pmc_34438993.pdf e564b1bb6fad8a02d3b857805221e2ca6c1e5e4e983edb4d7b47ae91f83d279a pmc_34438993.pdf Title: Antimicrobial Consumption among 66 Acute Care Hospitals in Catalonia: Impact of the COVID-19 Pandemic Subject: Background: Antimicrobials have been widely used during the COVID-19 pandemic. This study aimed to analyze the impact of the COVID-19 pandemic on the antimicrobial consumption of 66 hospitals in Catalonia. Methods: Adult antibacterial and antimycotic consumption was calculated as defined daily doses (DDD)/100 bed-days and DDD/100 discharges. Firstly, overall and ICU consumption in 2019 and 2020 were compared. Secondly, observed ICU 2020 consumptions were compared with non-COVID-19 2020 estimated consumptions (based on the trend from 2008–2019). Results: Overall, antibacterial consumption increased by 2.31% and 4.15% DDD/100 bed-days and DDD/100 discharges, respectively. Azithromycin (105.4% and 109.08% DDD/100 bed-days and DDD/100 discharges, respectively) and ceftriaxone (25.72% and 27.97% DDD/100 bed-days and DDD/100 discharges, respectively) mainly accounted for this finding. Likewise, antifungal consumption increased by 10.25% DDD/100 bed-days and 12.22% DDD/100 discharges, mainly due to echinocandins or amphotericin B. ICU antibacterial and antimycotic consumption decreased by 1.28% and 4.35% DDD/100 bed-days, respectively. On the contrary, antibacterial and antifungal use, expressed in DDD/100 discharges, increased by 23.42% and 19.58%. Azithromycin (275.09%), ceftriaxone (55.11%), cefepime (106.35%), vancomycin (29.81%), linezolid (31.28%), amphotericin B (87.98%), and voriconazole (96.17%) use changed the most. Observed consumption of amphotericin B, azithromycin, caspofungin, ceftriaxone, vancomycin, and voriconazole were higher than estimated values. Conclusions: The consumption indicators for most antimicrobials deviated from the expected trend pattern. A worrisome increase in antibacterial and antifungal consumption was observed in ICUs in Catalonia. Keywords: antimicrobial consumption; COVID-19; defined daily doses; antibiotics; antifungals Author: Santiago Grau, Sergi Hernández, Daniel Echeverría-Esnal, Alexander Almendral, Ricard Ferrer, Enric Limón, Juan Pablo Horcajada and on behalf of the Catalan Infection Control Antimicrobial Stewardship Program (VINCat-PROA) Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Mon Aug 9 15:04:24 2021 CEST ModDate: Fri Aug 13 07:07:51 2021 CEST Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 12 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1860691 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- VCUWWL+VnURWPalladioL Type 1 Custom yes yes no 10 0 TJEFKS+URWPalladioL-Ital Type 1 Custom yes yes no 15 0 KGPIAT+URWPalladioL-Bold Type 1 Custom yes yes no 20 0 YDXZME+URWPalladioL-Roma Type 1 Custom yes yes no 24 0 BDXMTO+CMSY10 Type 1 Builtin yes yes no 28 0 PRJKGQ+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 WBVKDJ+URWPalladioL-BoldItal Type 1 Custom yes yes no 92 0 SYVAVM+VnURWPalladioL-Italic Type 1 Custom yes yes no 124 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-10-02 03:06:22 CEST RepresentationInformation: pmc_34438993.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2023-03-31 12:14:54 CEST Size: 1860691 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 289 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Results Destination: section.2 Children: Item: Title: Evolution of COVID-19 Pandemic in Catalonia during 2020 Destination: subsection.2.1 Item: Title: Evolution of Overall and ICU Bed-Days and Discharges 2008 2020 Destination: subsection.2.2 Item: Title: Changes in Global Consumption of Anti-Infectives for Systemic Use 2019 2020 Destination: subsection.2.3 Item: Title: Changes in ICU Consumption of Anti-Infectives for Systemic Use 2019 2020 Destination: subsection.2.4 Item: Title: Comparison between Estimated and Observed ICU Consumption, Expressed in DDD/100 Discharges, in 2020 Destination: subsection.2.5 Item: Title: Discussion Destination: section.3 Item: Title: Materials and Methods Destination: section.4 Children: Item: Title: Setting and Study Design Destination: subsection.4.1 Item: Title: Data Collection Destination: subsection.4.2 Item: Title: Statistical Analysis Destination: subsection.4.3 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.5 Info: Title: Antimicrobial Consumption among 66 Acute Care Hospitals in Catalonia: Impact of the COVID-19 Pandemic Author: Santiago Grau, Sergi Hernández, Daniel Echeverría-Esnal, Alexander Almendral, Ricard Ferrer, Enric Limón, Juan Pablo Horcajada and on behalf of the Catalan Infection Control Antimicrobial Stewardship Program (VINCat-PROA) Subject: Background: Antimicrobials have been widely used during the COVID-19 pandemic. This study aimed to analyze the impact of the COVID-19 pandemic on the antimicrobial consumption of 66 hospitals in Catalonia. Methods: Adult antibacterial and antimycotic consumption was calculated as defined daily doses (DDD)/100 bed-days and DDD/100 discharges. Firstly, overall and ICU consumption in 2019 and 2020 were compared. Secondly, observed ICU 2020 consumptions were compared with non-COVID-19 2020 estimated consumptions (based on the trend from 2008 2019). Results: Overall, antibacterial consumption increased by 2.31% and 4.15% DDD/100 bed-days and DDD/100 discharges, respectively. Azithromycin (105.4% and 109.08% DDD/100 bed-days and DDD/100 discharges, respectively) and ceftriaxone (25.72% and 27.97% DDD/100 bed-days and DDD/100 discharges, respectively) mainly accounted for this finding. Likewise, antifungal consumption increased by 10.25% DDD/100 bed-days and 12.22% DDD/100 discharges, mainly due to echinocandins or amphotericin B. ICU antibacterial and antimycotic consumption decreased by 1.28% and 4.35% DDD/100 bed-days, respectively. On the contrary, antibacterial and antifungal use, expressed in DDD/100 discharges, increased by 23.42% and 19.58%. Azithromycin (275.09%), ceftriaxone (55.11%), cefepime (106.35%), vancomycin (29.81%), linezolid (31.28%), amphotericin B (87.98%), and voriconazole (96.17%) use changed the most. Observed consumption of amphotericin B, azithromycin, caspofungin, ceftriaxone, vancomycin, and voriconazole were higher than estimated values. Conclusions: The consumption indicators for most antimicrobials deviated from the expected trend pattern. A worrisome increase in antibacterial and antifungal consumption was observed in ICUs in Catalonia. 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