Tat Ming Ng1, Sock Hoon Tan2, Shi Thong Heng2, Hui Lin Tay2, Min Yi Yap2, Boon Hou Chua2, Christine B Teng2,3, David C Lye4,5,6,7, Tau Hong Lee4,5,6,7. 1. Department of Pharmacy, Tan Tock Seng Hospital, Singapore, Singapore. tat_ming_ng@ttsh.com.sg. 2. Department of Pharmacy, Tan Tock Seng Hospital, Singapore, Singapore. 3. Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore, Singapore. 4. Department of Infectious Diseases, National Centre for Infectious Diseases, Singapore, Singapore. 5. Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore, Singapore. 6. Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore. 7. Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Abstract
BACKGROUND: The deployment of antimicrobial stewardship (AMS) teams to deal with the COVID-19 pandemic can lead to a loss of developed frameworks, best practices and leadership resulting in adverse impact on antimicrobial prescribing and resistance. We aim to investigate effects of reduction in AMS resources during the COVID-19 pandemic on antimicrobial prescribing. METHODS: One of 5 full-time equivalent AMS pharmacists was deployed to support pandemic work and AMS rounds with infectious disease physicians were reduced from 5 to 2 times a week. A survey in acute inpatients was conducted using the Global Point Prevalence Survey methodology in July 2020 and compared with those in 2015 and 2017-2019. RESULTS: The prevalence of antimicrobial prescribing (55% in 2015 to 49% in 2019 and 47% in 2020, p = 0.02) and antibacterials (54% in 2015 to 45% in 2019 and 42% in 2020, p < 0.01) have been reducing despite the pandemic. Antimicrobial prescribing in infectious disease wards with suspected or confirmed COVID-19 cases was 29% in 2020. Overall, antimicrobial prescribing quality indicators continued to improve (e.g. reasons in notes, 91% in 2015 to 94% in 2019 and 97% in 2020, p < 0.01) or remained stable (compliance to guideline, 71% in 2015 to 62% in 2019 and 73% in 2020, p = 0.08). CONCLUSION: During the COVID-19 pandemic, there was no increase in antimicrobial prescribing and no significant differences in antimicrobial prescribing quality indicators.
BACKGROUND: The deployment of antimicrobial stewardship (AMS) teams to deal with the COVID-19 pandemic can lead to a loss of developed frameworks, best practices and leadership resulting in adverse impact on antimicrobial prescribing and resistance. We aim to investigate effects of reduction in AMS resources during the COVID-19 pandemic on antimicrobial prescribing. METHODS: One of 5 full-time equivalent AMS pharmacists was deployed to support pandemic work and AMS rounds with infectious disease physicians were reduced from 5 to 2 times a week. A survey in acute inpatients was conducted using the Global Point Prevalence Survey methodology in July 2020 and compared with those in 2015 and 2017-2019. RESULTS: The prevalence of antimicrobial prescribing (55% in 2015 to 49% in 2019 and 47% in 2020, p = 0.02) and antibacterials (54% in 2015 to 45% in 2019 and 42% in 2020, p < 0.01) have been reducing despite the pandemic. Antimicrobial prescribing in infectious disease wards with suspected or confirmed COVID-19 cases was 29% in 2020. Overall, antimicrobial prescribing quality indicators continued to improve (e.g. reasons in notes, 91% in 2015 to 94% in 2019 and 97% in 2020, p < 0.01) or remained stable (compliance to guideline, 71% in 2015 to 62% in 2019 and 73% in 2020, p = 0.08). CONCLUSION: During the COVID-19 pandemic, there was no increase in antimicrobial prescribing and no significant differences in antimicrobial prescribing quality indicators.
Authors: Bradley J Langford; Nick Daneman; Christina Diong; Alex Marchand-Austin; Kwaku Adomako; Arezou Saedi; Kevin L Schwartz; Jennie Johnstone; Derek R MacFadden; Larissa M Matukas; Samir N Patel; Gary Garber; Kevin A Brown Journal: Clin Microbiol Infect Date: 2020-10-12 Impact factor: 8.067
Authors: Timothy M Rawson; Luke S P Moore; Nina Zhu; Nishanthy Ranganathan; Keira Skolimowska; Mark Gilchrist; Giovanni Satta; Graham Cooke; Alison Holmes Journal: Clin Infect Dis Date: 2021-03-01 Impact factor: 9.079
Authors: Ann Versporten; Peter Zarb; Isabelle Caniaux; Marie-Françoise Gros; Nico Drapier; Mark Miller; Vincent Jarlier; Dilip Nathwani; Herman Goossens Journal: Lancet Glob Health Date: 2018-04-23 Impact factor: 26.763
Authors: Brian R Wood; Jeremy D Young; Rima C Abdel-Massih; Lewis McCurdy; Todd J Vento; Shireesha Dhanireddy; Kay J Moyer; Javeed Siddiqui; John D Scott Journal: Clin Infect Dis Date: 2021-03-15 Impact factor: 9.079
Authors: Timothy M Rawson; Luke S P Moore; Enrique Castro-Sanchez; Esmita Charani; Frances Davies; Giovanni Satta; Matthew J Ellington; Alison H Holmes Journal: J Antimicrob Chemother Date: 2020-07-01 Impact factor: 5.790
Authors: Charles Frenette; David Sperlea; Greg J German; Kevin Afra; Jennifer Boswell; Sandra Chang; Herman Goossens; Jennifer Grant; Marie-Astrid Lefebvre; Allison McGeer; Dominic Mertz; Michelle Science; Ann Versporten; Daniel J G Thirion Journal: Antimicrob Resist Infect Control Date: 2020-07-11 Impact factor: 4.887
Authors: Zia Ul Mustafa; Muhammad Salman Saleem; Muhammad Nabeel Ikram; Muhammad Salman; Sanan Amjad Butt; Shehroze Khan; Brian Godman; R Andrew Seaton Journal: Pathog Glob Health Date: 2021-11-16 Impact factor: 3.735