ArticleBMC infectious diseases2025
Antibiotic prescribing trends among Iranian GPs during COVID-19: a longitudinal analysis of antimicrobial resistance risks.
Article in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- National surveillance of antimicrobial resistance in Iran using IAMR software: A hospital-based study.New microbes and new infections · 2026Article
- Changing epidemiology of reproductive tract infections in Western China: a three-phase retrospective study during the COVID-19 pandemic.BMC infectious diseases · 2026Article
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4 authors.
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Abstract
backgroundAntimicrobial resistance (AMR) is a major global health threat, exacerbated by inappropriate antibiotic use. The COVID-19 pandemic disrupted prescribing behaviors worldwide. No previous study has comprehensively analyzed longitudinal antibiotic prescribing trends among Iranian general practitioners (GPs) across pre-, during-, and post-COVID periods. This study addresses this gap by examining 1,431,004 prescriptions from 73 GPs in Iran.
methodsWe conducted a retrospective cohort analysis using anonymized data from Iran’s National Hospital Information System (HIS), focusing on a central public clinic (representing ~ 7% of national GP prescriptions). Three periods were analyzed: pre-COVID (January 2019–December 2019), COVID (January 2020–May 2021), and post-COVID (June 2021–May 2022). Descriptive and inferential statistics (chi-square, Poisson regression, ANOVA) were used; p < 0.05 was considered significant.
resultsAntibiotic prescriptions rose from 107,365 (pre-COVID) to 200,433 (COVID), an 87% increase (95% CI: 82–92%; p < 0.001). Post-COVID, prescribing remained elevated (208,040; 94% above baseline). The antibiotic-to-total drug ratio doubled during COVID (7.6% to 14.4%, p < 0.001). Azithromycin use surged by 120% (p < 0.001), mainly for respiratory infections per national guidelines. Injectable penicillin G prescriptions dropped by 100% post-pandemic. Prescriptions per GP fell during COVID but rebounded after.
conclusionsThe sustained rise in broad-spectrum antibiotic prescribing by Iranian GPs during and after COVID-19 is likely to accelerate AMR in Iran. Urgent, locally tailored stewardship programs, GP education, and expanded rapid diagnostic testing are needed to curb unnecessary prescribing and protect public health.
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