COVID-19 pandemic and the quality of antibiotic use in primary care: an interrupted time-series study
Abstract The coronavirus disease-19 pandemic and the related public health mitigation measures have impacted the transmission of infectious diseases; however, their impact on the use of antibacterials has not yet been extensively evaluated. This study evaluated the impact of the pandemic on the cons...
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| Veröffentlicht in: | International journal for quality in health care 2023-05, Vol.35 (2) |
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| container_title | International journal for quality in health care |
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| creator | Domingues, Mariana Torre, Carla Guerreiro, José Pedro Barata, Pedro Correia-Neves, Margarida Rocha, João Sepodes, Bruno Teixeira Rodrigues, António |
| description | Abstract
The coronavirus disease-19 pandemic and the related public health mitigation measures have impacted the transmission of infectious diseases; however, their impact on the use of antibacterials has not yet been extensively evaluated. This study evaluated the impact of the pandemic on the consumption patterns of antibacterials for systemic use in primary care in Portugal. An interrupted time-series analysis was performed using the autoregressive integrated moving average model of the antibacterials dispensed in the community pharmacies in Portugal from 1 January 2016 to 30 June 2022. Monthly rates of absolute consumption (all antibacterials for systemic use, and specifically penicillins; cephalosporins; macrolides, lincosamides, and streptogramins; and quinolones) and the relative consumption of antibacterials (penicillins sensitive to β-lactamase, penicillin combinations including β-lactamase inhibitors, third- and fourth-generation cephalosporins, fluoroquinolones, and the ratio of broad- to narrow-spectrum antibacterials) were estimated. Antibiotic consumption was expressed in defined daily doses per 1000 inhabitants per day (DID). In Portugal, the consumption of antibacterials (J01) declined sharply immediately after the beginning of the pandemic, having a significant reduction of >5 DID (P |
| doi_str_mv | 10.1093/intqhc/mzad014 |
| format | Article |
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The coronavirus disease-19 pandemic and the related public health mitigation measures have impacted the transmission of infectious diseases; however, their impact on the use of antibacterials has not yet been extensively evaluated. This study evaluated the impact of the pandemic on the consumption patterns of antibacterials for systemic use in primary care in Portugal. An interrupted time-series analysis was performed using the autoregressive integrated moving average model of the antibacterials dispensed in the community pharmacies in Portugal from 1 January 2016 to 30 June 2022. Monthly rates of absolute consumption (all antibacterials for systemic use, and specifically penicillins; cephalosporins; macrolides, lincosamides, and streptogramins; and quinolones) and the relative consumption of antibacterials (penicillins sensitive to β-lactamase, penicillin combinations including β-lactamase inhibitors, third- and fourth-generation cephalosporins, fluoroquinolones, and the ratio of broad- to narrow-spectrum antibacterials) were estimated. Antibiotic consumption was expressed in defined daily doses per 1000 inhabitants per day (DID). In Portugal, the consumption of antibacterials (J01) declined sharply immediately after the beginning of the pandemic, having a significant reduction of >5 DID (P < .0001). A similar, short-term impact was found for penicillins (−2.920 DID; P < .0001); cephalosporins (−0.428 DID; P < .0001); macrolides, lincosamides, and streptogramins (−0.681 DID; P = .0021); and quinolones (−0.320 DID; P < .0001). A long-term increase was found for cephalosporins (+0.019 DID per month; P < .0001). Relative consumption changes were only found for third- and fourth-generation cephalosporins (0.0734%). Our study suggests that the coronavirus disease-19 pandemic may have resulted in a decrease in antibiotic use, with no significant changes in the relative dispense. Uncertainties regarding the long-term effects of the pandemic and its impact on the rates of resistance remain.</description><identifier>ISSN: 1353-4505</identifier><identifier>EISSN: 1464-3677</identifier><identifier>DOI: 10.1093/intqhc/mzad014</identifier><identifier>PMID: 37226230</identifier><language>eng</language><publisher>UK: Oxford University Press</publisher><subject>Anti-Bacterial Agents - therapeutic use ; Cephalosporins ; COVID-19 - epidemiology ; Humans ; Lincosamides ; Macrolides ; Pandemics ; Penicillins ; Primary Health Care ; Quinolones ; Streptogramins</subject><ispartof>International journal for quality in health care, 2023-05, Vol.35 (2)</ispartof><rights>The Author(s) 2023. Published by Oxford University Press on behalf of International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com 2023</rights><rights>The Author(s) 2023. Published by Oxford University Press on behalf of International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c369t-46af4eede66b5783fa8c0d8d8a91c0baf8010cbea1020e469aed8b2d835e30df3</citedby><cites>FETCH-LOGICAL-c369t-46af4eede66b5783fa8c0d8d8a91c0baf8010cbea1020e469aed8b2d835e30df3</cites><orcidid>0000-0002-8161-9264 ; 0000-0002-5542-9993</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,1579,1599,27905,27906</link.rule.ids><linktorsrc>$$Uhttps://dx.doi.org/10.1093/intqhc/mzad014$$EView_record_in_Oxford_University_Press$$FView_record_in_$$GOxford_University_Press</linktorsrc><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37226230$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Domingues, Mariana</creatorcontrib><creatorcontrib>Torre, Carla</creatorcontrib><creatorcontrib>Guerreiro, José Pedro</creatorcontrib><creatorcontrib>Barata, Pedro</creatorcontrib><creatorcontrib>Correia-Neves, Margarida</creatorcontrib><creatorcontrib>Rocha, João</creatorcontrib><creatorcontrib>Sepodes, Bruno</creatorcontrib><creatorcontrib>Teixeira Rodrigues, António</creatorcontrib><title>COVID-19 pandemic and the quality of antibiotic use in primary care: an interrupted time-series study</title><title>International journal for quality in health care</title><addtitle>Int J Qual Health Care</addtitle><description>Abstract
The coronavirus disease-19 pandemic and the related public health mitigation measures have impacted the transmission of infectious diseases; however, their impact on the use of antibacterials has not yet been extensively evaluated. This study evaluated the impact of the pandemic on the consumption patterns of antibacterials for systemic use in primary care in Portugal. An interrupted time-series analysis was performed using the autoregressive integrated moving average model of the antibacterials dispensed in the community pharmacies in Portugal from 1 January 2016 to 30 June 2022. Monthly rates of absolute consumption (all antibacterials for systemic use, and specifically penicillins; cephalosporins; macrolides, lincosamides, and streptogramins; and quinolones) and the relative consumption of antibacterials (penicillins sensitive to β-lactamase, penicillin combinations including β-lactamase inhibitors, third- and fourth-generation cephalosporins, fluoroquinolones, and the ratio of broad- to narrow-spectrum antibacterials) were estimated. Antibiotic consumption was expressed in defined daily doses per 1000 inhabitants per day (DID). In Portugal, the consumption of antibacterials (J01) declined sharply immediately after the beginning of the pandemic, having a significant reduction of >5 DID (P < .0001). A similar, short-term impact was found for penicillins (−2.920 DID; P < .0001); cephalosporins (−0.428 DID; P < .0001); macrolides, lincosamides, and streptogramins (−0.681 DID; P = .0021); and quinolones (−0.320 DID; P < .0001). A long-term increase was found for cephalosporins (+0.019 DID per month; P < .0001). Relative consumption changes were only found for third- and fourth-generation cephalosporins (0.0734%). Our study suggests that the coronavirus disease-19 pandemic may have resulted in a decrease in antibiotic use, with no significant changes in the relative dispense. Uncertainties regarding the long-term effects of the pandemic and its impact on the rates of resistance remain.</description><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Cephalosporins</subject><subject>COVID-19 - epidemiology</subject><subject>Humans</subject><subject>Lincosamides</subject><subject>Macrolides</subject><subject>Pandemics</subject><subject>Penicillins</subject><subject>Primary Health Care</subject><subject>Quinolones</subject><subject>Streptogramins</subject><issn>1353-4505</issn><issn>1464-3677</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkDtPwzAUhS0EoqWwMiKPMKS148RJ2FB5VarUBVgjx75RjfKqH0P59RglsDLdq3O_c6R7ELqmZElJwVa6c4e9XLVfQhGanKA5TXgSMZ5lp2FnKYuSlKQzdGHtJyGUs5SfoxnL4pjHjMwRrHcfm8eIFngQnYJWSxwmdnvABy8a7Y64r4PkdKV7F67eAtYdHoxuhTliKQzch3vQHBjjBwfBrVuILBgNFlvn1fESndWisXA1zQV6f356W79G293LZv2wjSTjhYsSLuoEQAHnVZrlrBa5JCpXuSioJJWoc0KJrEBQEhNIeCFA5VWscpYCI6pmC3Q75g6mP3iwrmy1ldA0ooPe2zLOaRFnPCNxQJcjKk1vrYG6nF4qKSl_qi3Hasup2mC4mbJ91YL6w3-7DMDdCPR--C_sG1vohog</recordid><startdate>20230524</startdate><enddate>20230524</enddate><creator>Domingues, Mariana</creator><creator>Torre, Carla</creator><creator>Guerreiro, José Pedro</creator><creator>Barata, Pedro</creator><creator>Correia-Neves, Margarida</creator><creator>Rocha, João</creator><creator>Sepodes, Bruno</creator><creator>Teixeira Rodrigues, António</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-8161-9264</orcidid><orcidid>https://orcid.org/0000-0002-5542-9993</orcidid></search><sort><creationdate>20230524</creationdate><title>COVID-19 pandemic and the quality of antibiotic use in primary care: an interrupted time-series study</title><author>Domingues, Mariana ; Torre, Carla ; Guerreiro, José Pedro ; Barata, Pedro ; Correia-Neves, Margarida ; Rocha, João ; Sepodes, Bruno ; Teixeira Rodrigues, António</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c369t-46af4eede66b5783fa8c0d8d8a91c0baf8010cbea1020e469aed8b2d835e30df3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Cephalosporins</topic><topic>COVID-19 - epidemiology</topic><topic>Humans</topic><topic>Lincosamides</topic><topic>Macrolides</topic><topic>Pandemics</topic><topic>Penicillins</topic><topic>Primary Health Care</topic><topic>Quinolones</topic><topic>Streptogramins</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Domingues, Mariana</creatorcontrib><creatorcontrib>Torre, Carla</creatorcontrib><creatorcontrib>Guerreiro, José Pedro</creatorcontrib><creatorcontrib>Barata, Pedro</creatorcontrib><creatorcontrib>Correia-Neves, Margarida</creatorcontrib><creatorcontrib>Rocha, João</creatorcontrib><creatorcontrib>Sepodes, Bruno</creatorcontrib><creatorcontrib>Teixeira Rodrigues, António</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>International journal for quality in health care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext_linktorsrc</fulltext></delivery><addata><au>Domingues, Mariana</au><au>Torre, Carla</au><au>Guerreiro, José Pedro</au><au>Barata, Pedro</au><au>Correia-Neves, Margarida</au><au>Rocha, João</au><au>Sepodes, Bruno</au><au>Teixeira Rodrigues, António</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>COVID-19 pandemic and the quality of antibiotic use in primary care: an interrupted time-series study</atitle><jtitle>International journal for quality in health care</jtitle><addtitle>Int J Qual Health Care</addtitle><date>2023-05-24</date><risdate>2023</risdate><volume>35</volume><issue>2</issue><issn>1353-4505</issn><eissn>1464-3677</eissn><abstract>Abstract
The coronavirus disease-19 pandemic and the related public health mitigation measures have impacted the transmission of infectious diseases; however, their impact on the use of antibacterials has not yet been extensively evaluated. This study evaluated the impact of the pandemic on the consumption patterns of antibacterials for systemic use in primary care in Portugal. An interrupted time-series analysis was performed using the autoregressive integrated moving average model of the antibacterials dispensed in the community pharmacies in Portugal from 1 January 2016 to 30 June 2022. Monthly rates of absolute consumption (all antibacterials for systemic use, and specifically penicillins; cephalosporins; macrolides, lincosamides, and streptogramins; and quinolones) and the relative consumption of antibacterials (penicillins sensitive to β-lactamase, penicillin combinations including β-lactamase inhibitors, third- and fourth-generation cephalosporins, fluoroquinolones, and the ratio of broad- to narrow-spectrum antibacterials) were estimated. Antibiotic consumption was expressed in defined daily doses per 1000 inhabitants per day (DID). In Portugal, the consumption of antibacterials (J01) declined sharply immediately after the beginning of the pandemic, having a significant reduction of >5 DID (P < .0001). A similar, short-term impact was found for penicillins (−2.920 DID; P < .0001); cephalosporins (−0.428 DID; P < .0001); macrolides, lincosamides, and streptogramins (−0.681 DID; P = .0021); and quinolones (−0.320 DID; P < .0001). A long-term increase was found for cephalosporins (+0.019 DID per month; P < .0001). Relative consumption changes were only found for third- and fourth-generation cephalosporins (0.0734%). Our study suggests that the coronavirus disease-19 pandemic may have resulted in a decrease in antibiotic use, with no significant changes in the relative dispense. Uncertainties regarding the long-term effects of the pandemic and its impact on the rates of resistance remain.</abstract><cop>UK</cop><pub>Oxford University Press</pub><pmid>37226230</pmid><doi>10.1093/intqhc/mzad014</doi><orcidid>https://orcid.org/0000-0002-8161-9264</orcidid><orcidid>https://orcid.org/0000-0002-5542-9993</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Anti-Bacterial Agents - therapeutic use Cephalosporins COVID-19 - epidemiology Humans Lincosamides Macrolides Pandemics Penicillins Primary Health Care Quinolones Streptogramins |
| title | COVID-19 pandemic and the quality of antibiotic use in primary care: an interrupted time-series study |
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