Division Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, Netherlands.
Directorate-General for Health and Food Safety, European Commission, Brussels, Belgium.
Eur J Clin Pharmacol. 2024 Oct;80(10):1581-1589. doi: 10.1007/s00228-024-03726-1. Epub 2024 Jul 17.
In the Spring of 2020, the world was hit with unparalleled impact by the coronavirus pandemic. Antibiotics were widely used, even without good rationale. The aim of our study was to compare the use of antibiotics in patients with confirmed COVID-19 from three hospitals across Europe (Poland, the Netherlands and Spain) between two subsequent periods in the early days of the pandemic.
We analysed data (antibiotics used and variation in the use of antibiotics, patients, admission and disease-related characteristics) from 300 patients admitted in three hospitals (University Hospital in Cracow, University Medical Center in Utrecht and Vall d'Hebron University Hospital in Barcelona) with confirmed infection of SARS-CoV-2 during Q1 2020 and Q4 2020.
There was ample variation in terms of patient mix and outcomes across the 3 hospitals. The majority of patients (225 out of 300) in all 3 hospitals received at least 1 antibiotic during the hospitalisation period. A minority of patients (68 out of 300) had their bacterial test results positive during their hospitalisation period. Throughout the 2 study periods, third-generation cephalosporins (ceftriaxone in 170 out of 300 patients) emerged as the most commonly used class of antibiotics. There was an apparent shift towards more rational utilisation of antibiotics, in all three hospitals.
Our study shows that during the early stage of COVID-19 pandemic in 2020, antibiotics were frequently used in three European teaching hospitals despite the relatively low incidence of microbiologically confirmed bacterial infections. While in the early days of the COVID-19 pandemic antibiotic prescribing was full of trial and error, we could also confirm a learning curve over time.
2020 年春天，全球受到了前所未有的冠状病毒大流行的冲击。抗生素被广泛使用，甚至没有合理的依据。我们的研究目的是比较三家欧洲医院（波兰、荷兰和西班牙）的确诊 COVID-19 患者在大流行早期的两个后续时期内使用抗生素的情况。
我们分析了 2020 年第一季度和第四季度在三家医院（克拉科夫大学医院、乌得勒支大学医学中心和巴塞罗那瓦尔登希伯伦大学医院）确诊感染 SARS-CoV-2 的 300 名患者的数据（使用的抗生素和抗生素使用的变化、患者、入院和疾病相关特征）。
三家医院的患者构成和结局存在很大差异。所有 3 家医院的大多数患者（300 例中有 225 例）在住院期间至少使用了 1 种抗生素。在住院期间，只有少数患者（300 例中有 68 例）的细菌检测结果呈阳性。在整个 2 个研究期间，第三代头孢菌素（300 例中有 170 例使用头孢曲松）成为最常用的抗生素类别。所有 3 家医院都明显倾向于更合理地使用抗生素。
我们的研究表明，在 2020 年 COVID-19 大流行的早期阶段，尽管微生物学证实的细菌感染发病率相对较低，但三家欧洲教学医院仍频繁使用抗生素。虽然在 COVID-19 大流行的早期阶段，抗生素的使用充满了尝试和错误，但我们也可以随着时间的推移确认一个学习曲线。
