Antimicrobial Stewardship During the Time of COVID-19

The COVID-19 pandemic, an unanticipated and unprecedented global public health crisis, laid a heavy burden on healthcare systems around the world. The hallmarks of the disease, lower respiratory tract infections and hypoxia, lead to a strain in resources due to the exponential increase in hospitalizations.

Antimicrobial stewardship programs and the use of antimicrobials were severely challenged during the early stages of the pandemic due to a scarcity of data on bacterial co-infections and a lack of therapeutic options.

In a recent study, Investigators set out to understand how COVID-19 impacted antimicrobial use and antimicrobial stewardship programs.

The team retrospectively reviewed cases during the first wave of COVID-19 in a 151 bed urban safety-net community hospital between March and June of 2020. The study included a total of 302 patients, of which 221 received empiric antimicrobials.

Findings from the study showed that the most common antimicrobials used were ceftriaxone and azithromycin. The use of ceftriaxone was shown to increase from 71 to 113 during the period the study was conducted, with an average therapy duration of 6 days and 8 days in the intensive care unit.

The use of procalcitonin was also documented in 37 cases and ranged from 0.09 to 12.57 with an average of 1.21. None of the cases examined had a documented bacterial co-infection.

This study demonstrates the common prescription of antimicrobials during the first wave of the pandemic. Antimicrobial stewardship programs were shown to successfully guide clinicians towards recommended guidelines for selection and duration.

Contagion spoke to Alfredo Mena Lora, MD, the Clinical Assistant Professor in the Department of Medicine and Medical Director of Infection Control at Saint Anthony Hospital, who presented the research at The Society for Healthcare Epidemiology of America Conference 2021, about the study.