For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
12
views
14
references
 Top references
cited by
10
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
1 collections
    0
    shares
      392
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Effects of coronavirus disease 2019 (COVID-19) pandemic on antimicrobial prevalence and prescribing in a tertiary hospital in Singapore

      research-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          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.

          Methods

          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.

          Results

          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).

          Conclusion

          During the COVID-19 pandemic, there was no increase in antimicrobial prescribing and no significant differences in antimicrobial prescribing quality indicators.

          Related collections

          Most cited references14

          • Record: found
          • Abstract: found
          • Article: not found

          Bacterial and fungal co-infection in individuals with coronavirus: A rapid review to support COVID-19 antimicrobial prescribing

          Timothy Rawson, Luke Moore, Nina Zhu … (2020)
          Abstract Background To explore and describe the current literature surrounding bacterial/fungal co-infection in patients with coronavirus infection. Methods MEDLINE, EMBASE, and Web of Science were searched using broad based search criteria relating to coronavirus and bacterial co-infection. Articles presenting clinical data for patients with coronavirus infection (defined as SARS-1, MERS, SARS-COV-2, and other coronavirus) and bacterial/fungal co-infection reported in English, Mandarin, or Italian were included. Data describing bacterial/fungal co-infections, treatments, and outcomes were extracted. Secondary analysis of studies reporting antimicrobial prescribing in SARS-COV-2 even in the absence of co-infection was performed. Results 1007 abstracts were identified. Eighteen full texts reported bacterial/fungal co-infection were included. Most studies did not identify or report bacterial/fungal coinfection (85/140;61%). 9/18 (50%) studies reported on COVID-19, 5/18 (28%) SARS-1, 1/18 (6%) MERS, and 3/18 (17%) other coronavirus. For COVID-19, 62/806 (8%) patients were reported as experiencing bacterial/fungal co-infection during hospital admission. Secondary analysis demonstrated wide use of broad-spectrum antibacterials, despite a paucity of evidence for bacterial coinfection. On secondary analysis, 1450/2010 (72%) of patients reported received antimicrobial therapy. No antimicrobial stewardship interventions were described. For non-COVID-19 cases bacterial/fungal co-infection was reported in 89/815 (11%) of patients. Broad-spectrum antibiotic use was reported. Conclusions Despite frequent prescription of broad-spectrum empirical antimicrobials in patients with coronavirus associated respiratory infections, there is a paucity of data to support the association with respiratory bacterial/fungal co-infection. Generation of prospective evidence to support development of antimicrobial policy and appropriate stewardship interventions specific for the COVID-19 pandemic are urgently required.
          Article 0 comments Cited 688 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Bacterial co-infection and secondary infection in patients with COVID-19: a living rapid review and meta-analysis

            Bradley Langford, Miranda So, Sumit Raybardhan … (2020)
            Background Bacterial co-pathogens are commonly identified in viral respiratory infections and are important causes of morbidity and mortality. The prevalence of bacterial infection in patients infected with SARS-CoV-2 is not well understood. Aims To determine the prevalence of bacterial co-infection (at presentation) and secondary infection (after presentation) in patients with COVID-19. Sources We performed a systematic search of MEDLINE, OVID Epub and EMBASE databases for English language literature from 2019 to April 16, 2020. Studies were included if they (a) evaluated patients with confirmed COVID-19 and (b) reported the prevalence of acute bacterial infection. Content Data were extracted by a single reviewer and cross-checked by a second reviewer. The main outcome was the proportion of COVID-19 patients with an acute bacterial infection. Any bacteria detected from non-respiratory-tract or non-bloodstream sources were excluded. Of 1308 studies screened, 24 were eligible and included in the rapid review representing 3338 patients with COVID-19 evaluated for acute bacterial infection. In the meta-analysis, bacterial co-infection (estimated on presentation) was identified in 3.5% of patients (95%CI 0.4–6.7%) and secondary bacterial infection in 14.3% of patients (95%CI 9.6–18.9%). The overall proportion of COVID-19 patients with bacterial infection was 6.9% (95%CI 4.3–9.5%). Bacterial infection was more common in critically ill patients (8.1%, 95%CI 2.3–13.8%). The majority of patients with COVID-19 received antibiotics (71.9%, 95%CI 56.1 to 87.7%). Implications Bacterial co-infection is relatively infrequent in hospitalized patients with COVID-19. The majority of these patients may not require empirical antibacterial treatment.
            Article 0 comments Cited 641 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              The epidemiology, diagnosis and treatment of COVID-19

              Pan Zhai, Yanbing Ding, Xia Wu … (2020)
              Highlights • The mean incubation period is 2-14 days, and the basic reproduction number is 2.24-3.58. • COVID-19 infection should be diagnosed clinically with typical respiratory syndromes coupled with recent exposure. • Chest computerized tomography (CT) could facilitate early diagnosis. • Public health measures, such as isolation, quarantine, social distancing and community containment, can curb COVID-19. • Clinical trials assessing antivirals, chloroquine, hydroxychloroquine, glucocorticoids, convalescent plasma transfusion against COVID-19.
              Article 0 comments Cited 374 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Contributors
                Tat Ming Ng:
                ORCID: http://orcid.org/0000-0002-4570-3266
                tat_ming_ng@ttsh.com.sg
                Journal
                Journal ID (nlm-ta): Antimicrob Resist Infect Control
                Journal ID (iso-abbrev): Antimicrob Resist Infect Control
                Title: Antimicrobial Resistance and Infection Control
                Publisher: BioMed Central (London )
                ISSN (Electronic): 2047-2994
                Publication date (Electronic): 3 February 2021
                Publication date PMC-release: 3 February 2021
                Publication date Collection: 2021
                Volume: 10
                Electronic Location Identifier: 28
                Affiliations
                [1 ]GRID grid.240988.f, Department of Pharmacy, , Tan Tock Seng Hospital, ; Singapore, Singapore
                [2 ]GRID grid.4280.e, ISNI 0000 0001 2180 6431, Department of Pharmacy, Faculty of Science, , National University of Singapore, ; Singapore, Singapore
                [3 ]GRID grid.508077.d, Department of Infectious Diseases, , National Centre for Infectious Diseases, ; Singapore, Singapore
                [4 ]GRID grid.240988.f, Department of Infectious Diseases, , Tan Tock Seng Hospital, ; Singapore, Singapore
                [5 ]GRID grid.59025.3b, ISNI 0000 0001 2224 0361, Lee Kong Chian School of Medicine, , Nanyang Technological University, ; Singapore, Singapore
                [6 ]GRID grid.4280.e, ISNI 0000 0001 2180 6431, Yong Loo Lin School of Medicine, , National University of Singapore, ; Singapore, Singapore
                Author information
                http://orcid.org/0000-0002-4570-3266
                Article
                Publisher ID: 898
                DOI: 10.1186/s13756-021-00898-8
                PMC ID: 7856610
                PubMed ID: 33536077
                SO-VID: 1f3396c0-2f5e-43d6-b746-d54d8c4800e9
                Copyright © © The Author(s) 2021
                License:

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                Date received : 23 October 2020
                Date accepted : 21 January 2021
                Categories
                Subject: Research
                Custom metadata
                issue-copyright-statement © The Author(s) 2021

                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: covid-19,antimicrobial prevalence,singapore,resources,antimicrobial stewardship,pandemic
                Data availability:
                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: covid-19, antimicrobial prevalence, singapore, resources, antimicrobial stewardship, pandemic

                Comments

                Comment on this article

                scite_

                Similar content392

                See all similar

                Cited by10

                See all cited by