UCL Great Ormond Street Institute of Child Health, London, UK.
The Health Foundation, London, UK.
J Antimicrob Chemother. 2022 Mar 31;77(4):1185-1188. doi: 10.1093/jac/dkac009.
The COVID-19 pandemic has severely impacted healthcare delivery and there are growing concerns that the pandemic will accelerate antimicrobial resistance.
To evaluate the impact of the COVID-19 pandemic on antibiotic prescribing in a tertiary paediatric hospital in London, UK.
Data on patient characteristics and antimicrobial administration for inpatients treated between 29 April 2019 and Sunday 28 March 2021 were extracted from the electronic health record (EHR). Interrupted time series analysis was used to evaluate antibiotic days of therapy (DOT) and the proportion of prescribed antibiotics from the WHO 'Access' class.
A total of 23 292 inpatient admissions were included. Prior to the pandemic there were an average 262 admissions per week compared with 212 during the pandemic period. Patient demographics were similar in the two periods but there was a shift in the specialities that patients had been admitted to. During the pandemic, there was a crude increase in antibiotic DOTs, from 801 weekly DOT before the pandemic to 846. The proportion of Access antibiotics decreased from 44% to 42%. However, after controlling for changes in patient characteristics, there was no evidence for the pandemic having an impact on antibiotic prescribing.
The patient population in a specialist children's hospital was affected by the COVID-19 pandemic, but after adjusting for these changes there was no evidence that antibiotic prescribing was significantly affected by the pandemic. This highlights both the value of routine, high-quality EHR data and importance of appropriate statistical methods that can adjust for underlying changes to populations when evaluating impacts of the pandemic on healthcare.
COVID-19 大流行严重影响了医疗保健的提供，人们越来越担心大流行将加速抗生素耐药性的出现。
评估 COVID-19 大流行对英国伦敦一家三级儿科医院抗生素处方的影响。
从电子病历（EHR）中提取了 2019 年 4 月 29 日至 2021 年 3 月 28 日星期日期间住院患者的患者特征和抗菌药物管理数据。采用中断时间序列分析评估抗生素治疗日（DOT）和世界卫生组织“准入”类别中规定的抗生素比例。
共纳入 23292 例住院患者。大流行前每周平均有 262 例入院，而大流行期间每周有 212 例入院。两个时期的患者人口统计学特征相似，但入院患者的专科发生了变化。大流行期间，抗生素 DOT 略有增加，从大流行前每周 801 个 DOT 增加到 846 个。准入抗生素的比例从 44%下降到 42%。然而，在控制患者特征变化后，没有证据表明大流行对抗生素处方有影响。
一家专门儿童医院的患者人群受到 COVID-19 大流行的影响，但在调整这些变化后，没有证据表明抗生素处方受到大流行的显著影响。这既强调了常规、高质量的 EHR 数据的价值，也强调了在评估大流行对医疗保健的影响时，能够根据人群的潜在变化进行调整的适当统计方法的重要性。
