Department of Pharmacy, Tan Tock Seng Hospital, Singapore, Singapore.
Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore, Singapore.
Antimicrob Resist Infect Control. 2021 Feb 3;10(1):28. doi: 10.1186/s13756-021-00898-8.
The deployment of antimicrobial stewardship (AMS) teams to deal with the COVID-19 pandemic can lead to a loss of developed frameworks, best practices and leadership resulting in adverse impact on antimicrobial prescribing and resistance. We aim to investigate effects of reduction in AMS resources during the COVID-19 pandemic on antimicrobial prescribing.
One of 5 full-time equivalent AMS pharmacists was deployed to support pandemic work and AMS rounds with infectious disease physicians were reduced from 5 to 2 times a week. A survey in acute inpatients was conducted using the Global Point Prevalence Survey methodology in July 2020 and compared with those in 2015 and 2017-2019.
The prevalence of antimicrobial prescribing (55% in 2015 to 49% in 2019 and 47% in 2020, p = 0.02) and antibacterials (54% in 2015 to 45% in 2019 and 42% in 2020, p < 0.01) have been reducing despite the pandemic. Antimicrobial prescribing in infectious disease wards with suspected or confirmed COVID-19 cases was 29% in 2020. Overall, antimicrobial prescribing quality indicators continued to improve (e.g. reasons in notes, 91% in 2015 to 94% in 2019 and 97% in 2020, p < 0.01) or remained stable (compliance to guideline, 71% in 2015 to 62% in 2019 and 73% in 2020, p = 0.08).
During the COVID-19 pandemic, there was no increase in antimicrobial prescribing and no significant differences in antimicrobial prescribing quality indicators.
部署抗菌药物管理（AMS）团队应对 COVID-19 大流行可能导致已建立的框架、最佳实践和领导力丧失，从而对抗菌药物处方和耐药性产生不利影响。我们旨在研究 COVID-19 大流行期间减少 AMS 资源对抗菌药物处方的影响。
一名全职当量的 AMS 药剂师被部署来支持大流行工作，与传染病医生的 AMS 查房从每周 5 次减少到 2 次。2020 年 7 月采用全球时点患病率调查方法对急性住院患者进行了调查，并与 2015 年和 2017-2019 年的数据进行了比较。
尽管发生了大流行，但抗菌药物处方（2015 年为 55%，2019 年为 49%，2020 年为 47%，p=0.02）和抗菌药物（2015 年为 54%，2019 年为 45%，2020 年为 42%，p<0.01）的使用率一直在下降。疑似或确诊 COVID-19 病例的传染病病房中抗菌药物的处方率为 2020 年为 29%。总体而言，抗菌药物处方质量指标持续改善（例如，在医嘱中注明用药理由，2015 年为 91%，2019 年为 94%，2020 年为 97%，p<0.01）或保持稳定（符合指南，2015 年为 71%，2019 年为 62%，2020 年为 73%，p=0.08）。
在 COVID-19 大流行期间，抗菌药物处方没有增加，抗菌药物处方质量指标没有显著差异。
