Antibiotic resistance and consumption before and during the COVID-19 pandemic in Valle del Cauca, Colombia.

OBJECTIVE

To assess changes in antibiotic resistance of eight of the World Health Organization priority bug-drug combinations and consumption of six antibiotics (ceftriaxone, cefepime, piperacillin/tazobactam, meropenem, ciprofloxacin, vancomycin) before (March 2018 to July 2019) and during (March 2020 to July 2021) the COVID-19 pandemic in 31 hospitals in Valle del Cauca, Colombia.

METHODS

This was a before/after study using routinely collected data. For antibiotic consumption, daily defined doses (DDD) per 100 bed-days were compared.

RESULTS

There were 23 405 priority bacterial isolates with data on antibiotic resistance. The total number of isolates increased from 9 774 to 13 631 in the periods before and during the pandemic, respectively. While resistance significantly decreased for four selected bug-drug combinations (, extended spectrum beta lactamase [ESBL]-producing, 32% to 24%; , carbapenem-resistant, 4% to 2%; , carbapenem-resistant, 12% to 8%; , carbapenem-resistant, 23% to 9%), the level of resistance for to vancomycin significantly increased (42% to 57%). There was no change in resistance for the remaining three combinations (, methicillin-resistant; , ESBL-producing; , carbapenem-resistant). Consumption of all antibiotics increased. However, meropenem consumption decreased in intensive care unit settings (8.2 to 7.1 DDD per 100 bed-days).

CONCLUSIONS

While the consumption of antibiotics increased, a decrease in antibiotic resistance of four bug-drug combinations was observed during the pandemic. This was possibly due to an increase in community-acquired infections. Increasing resistance of to vancomycin must be monitored. The findings of this study are essential to inform stewardship programs in hospital settings of Colombia and similar contexts elsewhere.