The pattern of antibiotic utilisation among intensive care unit patients hospitalised in a Gauteng (South African) provincial tertiary hospital: Comparing findings before and during COVID-19
Background. Various mechanisms may contribute to and direct the progression of antibiotic resistance. A prominent driver associated with antibiotic resistance is inappropriate use or consumption. The sudden emergence of coronavirus disease 2019 (COVID-19 ) changed the conventional practices rel...
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South African Medical Association
2024-07-01
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| Series: | South African Medical Journal |
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| Online Access: | https://samajournals.co.za/index.php/samj/article/view/1812 |
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| author | L Spinickum Z Booth S Leigh-de Rapper |
| author_facet | L Spinickum Z Booth S Leigh-de Rapper |
| author_sort | L Spinickum |
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Background. Various mechanisms may contribute to and direct the progression of antibiotic resistance. A prominent driver associated with antibiotic resistance is inappropriate use or consumption. The sudden emergence of coronavirus disease 2019 (COVID-19 ) changed the conventional practices related to antibiotic utilisation through repurposing the use of antibiotics. Apart from the implementation of antibiotic stewardship programmes, the pressure COVID-19 placed on healthcare systems resulted in poor prescribing and medication review practices, potentially exacerbating antibiotic resistance. Furthermore, the public health system has issues that make it difficult to routinely monitor, quantify antibiotic consumption, and offer evaluation, feedback and intervention, particularly in low- and middle- income countries such as South Africa (SA). Therefore, this study aimed to determine antibiotic utilisation before and during the COVID-19 pandemic in a Gauteng provincial tertiary hospital (GPTH) in SA.
Objective. To determine, examine, and compare antibiotic consumption among intensive care unit (ICU) patients admitted to a GPTH during the pre-COVID-19 period and during the COVID-19 pandemic, in addition to determining the prevalence of the World Health Organisation (WHO) ‘watch’ category antibiotics before and following the emergence of COVID-19 .
Methods. A retrospective cross-sectional data analysis was undertaken of 335 medical files of ICU patients hospitalised in a GPTH between January 2017 and December 2021. Descriptive statistics were used to examine patient characteristics and antibiotic prescribing variables (antibiotic selection, dosage, route of administration, frequency, duration of course and indication for which antibiotic was prescribed).
Results. The study found that the most frequently prescribed antibiotics were amoxicillin in combination with clavulanate (pre-pandemic 31.99%; amid-COVID-19 38.43%), followed by ceftriaxone (pre-pandemic 15.44%; amid-COVID-19 14.55%), piperacillin in combination with tazobactam (pre-pandemic 11.40%; amid-COVID-19 8.58%) and azithromycin (pre-pandemic 7.725%; amid-COVID-19 19.78%).
Conclusion. The macrolide and penicillin (in combination with a beta-lactamase inhibitor) classes demonstrated an increase in consumption from the pre-pandemic period moving into the COVID-19 pandemic. This highlights the need for improved antibiotic stewardship programmes and policies to combat inappropriate and unnecessary antibiotic usage.
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| format | Article |
| id | doaj-art-384d2648a430418391cff64da07b50b5 |
| institution | Kabale University |
| issn | 0256-9574 2078-5135 |
| language | English |
| publishDate | 2024-07-01 |
| publisher | South African Medical Association |
| record_format | Article |
| series | South African Medical Journal |
| spelling | doaj-art-384d2648a430418391cff64da07b50b52025-02-10T12:25:51ZengSouth African Medical AssociationSouth African Medical Journal0256-95742078-51352024-07-01114710.7196/SAMJ.2024.v114i17.1812The pattern of antibiotic utilisation among intensive care unit patients hospitalised in a Gauteng (South African) provincial tertiary hospital: Comparing findings before and during COVID-19L Spinickum0https://orcid.org/0000-0001-6724-8834Z Booth1https://orcid.org/0000-0001-7399-8666S Leigh-de Rapper2https://orcid.org/0000-0003-3945-9823Department of Pharmacy and Pharmacology, School of Therapeutic Science, Faculty of Health Science, University of the Witwatersrand, Johannesburg, South AfricaDepartment of Pharmacy and Pharmacology, School of Therapeutic Science, Faculty of Health Science, University of the Witwatersrand, Johannesburg, South AfricaDepartment of Pharmacy and Pharmacology, School of Therapeutic Science, Faculty of Health Science, University of the Witwatersrand, Johannesburg, South Africa Background. Various mechanisms may contribute to and direct the progression of antibiotic resistance. A prominent driver associated with antibiotic resistance is inappropriate use or consumption. The sudden emergence of coronavirus disease 2019 (COVID-19 ) changed the conventional practices related to antibiotic utilisation through repurposing the use of antibiotics. Apart from the implementation of antibiotic stewardship programmes, the pressure COVID-19 placed on healthcare systems resulted in poor prescribing and medication review practices, potentially exacerbating antibiotic resistance. Furthermore, the public health system has issues that make it difficult to routinely monitor, quantify antibiotic consumption, and offer evaluation, feedback and intervention, particularly in low- and middle- income countries such as South Africa (SA). Therefore, this study aimed to determine antibiotic utilisation before and during the COVID-19 pandemic in a Gauteng provincial tertiary hospital (GPTH) in SA. Objective. To determine, examine, and compare antibiotic consumption among intensive care unit (ICU) patients admitted to a GPTH during the pre-COVID-19 period and during the COVID-19 pandemic, in addition to determining the prevalence of the World Health Organisation (WHO) ‘watch’ category antibiotics before and following the emergence of COVID-19 . Methods. A retrospective cross-sectional data analysis was undertaken of 335 medical files of ICU patients hospitalised in a GPTH between January 2017 and December 2021. Descriptive statistics were used to examine patient characteristics and antibiotic prescribing variables (antibiotic selection, dosage, route of administration, frequency, duration of course and indication for which antibiotic was prescribed). Results. The study found that the most frequently prescribed antibiotics were amoxicillin in combination with clavulanate (pre-pandemic 31.99%; amid-COVID-19 38.43%), followed by ceftriaxone (pre-pandemic 15.44%; amid-COVID-19 14.55%), piperacillin in combination with tazobactam (pre-pandemic 11.40%; amid-COVID-19 8.58%) and azithromycin (pre-pandemic 7.725%; amid-COVID-19 19.78%). Conclusion. The macrolide and penicillin (in combination with a beta-lactamase inhibitor) classes demonstrated an increase in consumption from the pre-pandemic period moving into the COVID-19 pandemic. This highlights the need for improved antibiotic stewardship programmes and policies to combat inappropriate and unnecessary antibiotic usage. https://samajournals.co.za/index.php/samj/article/view/1812antibioticsantibiotic prescribingantibiotic useAwaRE antibioticsCOVIDPDD |
| spellingShingle | L Spinickum Z Booth S Leigh-de Rapper The pattern of antibiotic utilisation among intensive care unit patients hospitalised in a Gauteng (South African) provincial tertiary hospital: Comparing findings before and during COVID-19 South African Medical Journal antibiotics antibiotic prescribing antibiotic use AwaRE antibiotics COVID PDD |
| title | The pattern of antibiotic utilisation among intensive care unit patients hospitalised in a Gauteng (South African) provincial tertiary hospital: Comparing findings before and during COVID-19 |
| title_full | The pattern of antibiotic utilisation among intensive care unit patients hospitalised in a Gauteng (South African) provincial tertiary hospital: Comparing findings before and during COVID-19 |
| title_fullStr | The pattern of antibiotic utilisation among intensive care unit patients hospitalised in a Gauteng (South African) provincial tertiary hospital: Comparing findings before and during COVID-19 |
| title_full_unstemmed | The pattern of antibiotic utilisation among intensive care unit patients hospitalised in a Gauteng (South African) provincial tertiary hospital: Comparing findings before and during COVID-19 |
| title_short | The pattern of antibiotic utilisation among intensive care unit patients hospitalised in a Gauteng (South African) provincial tertiary hospital: Comparing findings before and during COVID-19 |
| title_sort | pattern of antibiotic utilisation among intensive care unit patients hospitalised in a gauteng south african provincial tertiary hospital comparing findings before and during covid 19 |
| topic | antibiotics antibiotic prescribing antibiotic use AwaRE antibiotics COVID PDD |
| url | https://samajournals.co.za/index.php/samj/article/view/1812 |
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