Haverkate Manon R, Macfadden Derek R, Daneman Nick, Leal Jenine, Otterstatter Michael, Mahdavi Roshanak, D'Souza Adam G, Rennert-May Elissa, Silverman Michael, Schwartz Kevin L, Morris Andrew M, Saatchi Ariana, Patrick David M, Marra Fawziah
Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC V6T 1Z3, Canada.
Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON K1Y 4E9, Canada.
Antibiotics (Basel). 2022 Jul 26;11(8):1001. doi: 10.3390/antibiotics11081001.
The COVID-19 pandemic affected access to care, and the associated public health measures influenced the transmission of other infectious diseases. The pandemic has dramatically changed antibiotic prescribing in the community. We aimed to determine the impact of the COVID-19 pandemic and the resulting control measures on oral antibiotic prescribing in long-term care facilities (LTCFs) in Alberta and Ontario, Canada using linked administrative data. Antibiotic prescription data were collected for LTCF residents 65 years and older in Alberta and Ontario from 1 January 2017 until 31 December 2020. Weekly prescription rates per 1000 residents, stratified by age, sex, antibiotic class, and selected individual agents, were calculated. Interrupted time series analyses using SARIMA models were performed to test for changes in antibiotic prescription rates after the start of the pandemic (1 March 2020). The average annual cohort size was 18,489 for Alberta and 96,614 for Ontario. A significant decrease in overall weekly prescription rates after the start of the pandemic compared to pre-pandemic was found in Alberta, but not in Ontario. Furthermore, a significant decrease in prescription rates was observed for antibiotics mainly used to treat respiratory tract infections: amoxicillin in both provinces (Alberta: −0.6 per 1000 LTCF residents decrease in weekly prescription rate, p = 0.006; Ontario: −0.8, p < 0.001); and doxycycline (−0.2, p = 0.005) and penicillin (−0.04, p = 0.014) in Ontario. In Ontario, azithromycin was prescribed at a significantly higher rate after the start of the pandemic (0.7 per 1000 LTCF residents increase in weekly prescription rate, p = 0.011). A decrease in prescription rates for antibiotics that are largely used to treat respiratory tract infections is in keeping with the lower observed rates for respiratory infections resulting from pandemic control measures. The results should be considered in the contexts of different LTCF systems and provincial public health responses to the pandemic.
新冠疫情影响了医疗服务的可及性，相关公共卫生措施也影响了其他传染病的传播。这场疫情极大地改变了社区抗生素的处方情况。我们旨在利用关联的行政数据，确定新冠疫情及其导致的防控措施对加拿大艾伯塔省和安大略省长期护理机构（LTCFs）口服抗生素处方的影响。收集了2017年1月1日至2020年12月31日期间艾伯塔省和安大略省65岁及以上长期护理机构居民的抗生素处方数据。计算了每1000名居民按年龄、性别、抗生素类别和选定的个别药物分层的每周处方率。使用SARIMA模型进行中断时间序列分析，以测试疫情开始后（2020年3月1日）抗生素处方率的变化。艾伯塔省的平均年度队列规模为18489人，安大略省为96614人。与疫情前相比，艾伯塔省在疫情开始后总体每周处方率显著下降，但安大略省没有。此外，主要用于治疗呼吸道感染的抗生素处方率显著下降：两个省份的阿莫西林（艾伯塔省：每周处方率每1000名长期护理机构居民下降0.6，p = 0.006；安大略省：−0.8，p < 0.001）；安大略省的强力霉素（−0.2，p = 0.005）和青霉素（−0.04，p = 0.014）。在安大略省，疫情开始后阿奇霉素的处方率显著更高（每周处方率每1000名长期护理机构居民增加0.7，p = 0.011）。主要用于治疗呼吸道感染的抗生素处方率下降与疫情防控措施导致的呼吸道感染发病率降低相一致。应结合不同的长期护理机构系统和各省对疫情的公共卫生应对措施来考虑这些结果。
