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Impact of the COVID-19 Pandemic on Antimicrobial Consumption and Hospital-Acquired Candidemia and Multidrug-Resistant Bloodstream Infections

1
Infectious Diseases Research Group, Clinical Unit of Infectious Diseases, Microbiology and Preventive Medicine, Institute of Biomedicine of Seville (IBiS), University of Seville/CSIC/University Hospital Virgen del Rocio, Avenue Manuel Siurot, 41013 Seville, Spain
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Clinical Unit of Pharmacy, University Hospital Virgen del Rocio, 41013 Seville, Spain
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Clinical Unit of Emergency, University Hospital Virgen del Rocio, 41013 Seville, Spain
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Clinical Unit of Cardiology, University Hospital Virgen del Rocio, 41013 Seville, Spain
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Department of Medicine, University of Seville, 41004 Seville, Spain
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Intensive Care Department, University Hospital Virgen del Rocio, 41013 Seville, Spain
*
Author to whom correspondence should be addressed.
Membership of the PRIOAM Team is provided in the Acknowledgments.
Antibiotics 2020, 9(11), 816; https://doi.org/10.3390/antibiotics9110816
Received: 17 October 2020 / Revised: 10 November 2020 / Accepted: 15 November 2020 / Published: 17 November 2020
(This article belongs to the Section Antibiotics Use and Antimicrobial Stewardship)
During the COVID-19 pandemic, the implementation of antimicrobial stewardship strategies has been recommended. This study aimed to assess the impact of the COVID-19 pandemic in a tertiary care Spanish hospital with an active ongoing antimicrobial stewardship programme (ASP). For a 20-week period, we weekly assessed antimicrobial consumption, incidence density, and crude death rate per 1000 occupied bed days of candidemia and multidrug-resistant (MDR) bacterial bloodstream infections (BSI). We conducted a segmented regression analysis of time series. Antimicrobial consumption increased +3.5% per week (p = 0.016) for six weeks after the national lockdown, followed by a sustained weekly reduction of −6.4% (p = 0.001). The global trend for the whole period was stable. The frequency of empirical treatment of patients with COVID-19 was 33.7%. No change in the global trend of incidence of hospital-acquired candidemia and MDR bacterial BSI was observed (+0.5% weekly; p = 0.816), nor differences in 14 and 30-day crude death rates (p = 0.653 and p = 0.732, respectively). Our work provides quantitative data about the pandemic effect on antimicrobial consumption and clinical outcomes in a centre with an active ongoing institutional and education-based ASP. However, assessing the long-term impact of the COVID-19 pandemic on antimicrobial resistance is required. View Full-Text
Keywords: COVID-19; antimicrobial stewardship; anti-infective agents; bacteremia; candidemia COVID-19; antimicrobial stewardship; anti-infective agents; bacteremia; candidemia
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MDPI and ACS Style

Guisado-Gil, A.B.; Infante-Domínguez, C.; Peñalva, G.; Praena, J.; Roca, C.; Navarro-Amuedo, M.D.; Aguilar-Guisado, M.; Espinosa-Aguilera, N.; Poyato-Borrego, M.; Romero-Rodríguez, N.; Aldabó, T.; Salto-Alejandre, S.; Ruiz-Pérez de Pipaón, M.; Lepe, J.A.; Martín-Gutiérrez, G.; Gil-Navarro, M.V.; Molina, J.; Pachón, J.; Cisneros, J.M.; On behalf of the PRIOAM Team. Impact of the COVID-19 Pandemic on Antimicrobial Consumption and Hospital-Acquired Candidemia and Multidrug-Resistant Bloodstream Infections. Antibiotics 2020, 9, 816. https://doi.org/10.3390/antibiotics9110816

AMA Style

Guisado-Gil AB, Infante-Domínguez C, Peñalva G, Praena J, Roca C, Navarro-Amuedo MD, Aguilar-Guisado M, Espinosa-Aguilera N, Poyato-Borrego M, Romero-Rodríguez N, Aldabó T, Salto-Alejandre S, Ruiz-Pérez de Pipaón M, Lepe JA, Martín-Gutiérrez G, Gil-Navarro MV, Molina J, Pachón J, Cisneros JM, On behalf of the PRIOAM Team. Impact of the COVID-19 Pandemic on Antimicrobial Consumption and Hospital-Acquired Candidemia and Multidrug-Resistant Bloodstream Infections. Antibiotics. 2020; 9(11):816. https://doi.org/10.3390/antibiotics9110816

Chicago/Turabian Style

Guisado-Gil, Ana Belen, Carmen Infante-Domínguez, Germán Peñalva, Julia Praena, Cristina Roca, María Dolores Navarro-Amuedo, Manuela Aguilar-Guisado, Nuria Espinosa-Aguilera, Manuel Poyato-Borrego, Nieves Romero-Rodríguez, Teresa Aldabó, Sonsoles Salto-Alejandre, Maite Ruiz-Pérez de Pipaón, José Antonio Lepe, Guillermo Martín-Gutiérrez, María Victoria Gil-Navarro, José Molina, Jerónimo Pachón, José Miguel Cisneros, and On behalf of the PRIOAM Team. 2020. "Impact of the COVID-19 Pandemic on Antimicrobial Consumption and Hospital-Acquired Candidemia and Multidrug-Resistant Bloodstream Infections" Antibiotics 9, no. 11: 816. https://doi.org/10.3390/antibiotics9110816

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