Ul Mustafa, Z; Batool, A; Ibrar, H; Salman, M; Khan, YH; Mallhi, TH; Meyer, JC; Godman, B; Moore, CE
(2023)
Bacterial co-infections, secondary infections and antimicrobial use among hospitalized COVID-19 patients in the sixth wave in Pakistan: findings and implications.
Expert Rev Anti Infect Ther, 22 (4).
pp. 229-240.
ISSN 1744-8336
https://doi.org/10.1080/14787210.2023.2299387
SGUL Authors: Moore, Catrin Elisabeth
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Abstract
INTRODUCTION: Previous studies in Pakistan have shown considerable over prescribing of antibiotics in patients hospitalized with COVID-19 despite very low prevalence of bacterial infections. Irrational use of antibiotics will worsen antimicrobial resistance (AMR). METHODS: Retrospective analysis of medical records of patients in the COVID-19 wards of three tertiary care hospitals to assess antibiotic use during the sixth COVID-19 wave. RESULTS: A total of 284 patients were included, most were male (66.9%), aged 30-50 years (50.7%) with diabetes mellitus the most common comorbidity. The most common symptoms at presentation were cough (47.9%) and arthralgia-myalgia (41.5%). Around 3% were asymptomatic, 34.9% had mild, 30.3% moderate, and 23.6% had severe disease, with 8.1% critical. Chest X-ray abnormalities were seen in 43.3% of patients and 37% had elevated white cell counts, with 35.2% having elevated C-reactive protein levels. Around 91% COVID-19 patients were prescribed antibiotics during their hospital stay, with only a few with proven bacterial co-infections or secondary bacterial infections. Most antibiotics were from the 'Watch' category (90.8%) followed by the 'Reserve' category (4.8%), similar to previous COVID-19 waves. CONCLUSION: There continued to be excessive antibiotics use among hospitalized COVID-19 patients in Pakistan. Urgent measures are needed to address inappropriate prescribing including greater prescribing of Access antibiotics where pertinent.
Item Type: | Article | ||||||||
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Additional Information: | © 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent. | ||||||||
Keywords: | AWaRe classification, Antibiotics, COVID-19, Pakistan, antibiotic stewardship programs, hospitalized patients, tertiary care, Antibiotics, AWaRe classification, antibiotic stewardship programs, COVID-19, hospitalized patients, tertiary care, Pakistan, 1103 Clinical Sciences, Microbiology | ||||||||
SGUL Research Institute / Research Centre: | Academic Structure > Infection and Immunity Research Institute (INII) | ||||||||
Journal or Publication Title: | Expert Rev Anti Infect Ther | ||||||||
ISSN: | 1744-8336 | ||||||||
Language: | eng | ||||||||
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Publisher License: | Creative Commons: Attribution-Noncommercial-No Derivative Works 4.0 | ||||||||
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PubMed ID: | 38146949 | ||||||||
Web of Science ID: | WOS:001147081200001 | ||||||||
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URI: | https://openaccess.sgul.ac.uk/id/eprint/115863 | ||||||||
Publisher's version: | https://doi.org/10.1080/14787210.2023.2299387 |
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