Observational studyResearch in social & administrative pharmacy : RSAP2022
Antibiotic prescribing trends in the US during the first 11 months of the COVID-19 pandemic.
Observational study in Research in social & administrative pharmacy : RSAP, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed, 6 citations in OpenAlex.
- The Evolving Challenge of Appropriate Antibiotics Use in Hospitalized COVID-19 Patients: A Systematic Literature Review.Antibiotics (Basel, Switzerland) · 2024Review
- The Hidden Cost of COVID-19: Focus on Antimicrobial Resistance in Bloodstream Infections.Microorganisms · 2023Review
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe study aims to compare antibiotic prescribing trends for U.S. COVID-19 patients, categorized by disease severity, and non-COVID-19 population with similar symptoms during 2019-2020 pandemic.
methodsA retrospective observational cohort design using Symphony Health (January-November 2020). Sample population included about 13.3 million patients with at least one prescription claim ±6 months from date of diagnosis of COVID-19 or COVID-19 like symptom. Cohorts were categorized based on diagnosis codes; COVID-19 positive cohorts 1 to 3 with severe, mild, and no symptoms, respectively and non-COVID-19 cohorts 4 and 5 with severe and mild symptoms, respectively. Descriptive statistics were calculated for demographic characteristics and acute antibiotic utilization (≤7 days) including total number of antibiotics, weekly rate of prescribing, and proportion of fills in three "appropriateness" categories (always appropriate, potentially appropriate, never appropriate).
resultsThree cohorts with a positive COVID-19 diagnosis code constituted a total of about 1.8 million patients (13.53%). About 22.79% of COVID-19 positive groups had severe symptoms, 24.43% had moderate symptoms and the majority, 52.78%, had no symptoms. In the analytical sample of 13 million, about 4.2 million antibiotic prescriptions were prescribed to 2.5 million patients (19%) within 7 days of the first diagnosis of either COVID-19 or COVID-19-like symptoms. Within the COVID-19 positive cohorts, about 11% received an antibiotic prescription, while the non-COVID-19 cohorts, about 19.70% received an antibiotic. Among patients with antibiotic prescriptions, about 37.01% were prescribed an antibiotic "appropriately", 39.46% were prescribed a "potentially appropriate" antibiotic and about 22.64% received an "inappropriate" antibiotic. Among patients prescribed antibiotics, azithromycin was the most common, ranging from 21.80 to 44.80% for each cohort.
conclusionsAlthough the overall proportion of COVID-19 patients receiving antibiotics was much lower than non-COVID-19 patients, the findings suggest use of antibiotics persisted despite guidelines against widespread use, particularly for patients with moderate and mild COVID-19 symptoms.
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