Open AccessThe Spectrum of Antibiotic Prescribing During COVID-19 Pandemic: A Systematic Literature Review
Author(s) -
Sara H. Al-Hadidi,
Hashim Alhussain,
Hamad Abdel Hadi,
Al-Reem A. Johar,
Hadi M. Yassine,
Asmaa A. Al Thani,
Nahla O. Eltai
Publication year - 2021
Publication title -
microbial drug resistance
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.889
H-Index - 70
eISSN - 1931-8448
pISSN - 1076-6294
DOI - 10.1089/mdr.2020.0619
Subject(s) - medicine , pandemic , antibiotics , antimicrobial , adverse effect , covid-19 , antibiotic resistance , intensive care medicine , pediatrics , broad spectrum , systematic review , disease , medline , infectious disease (medical specialty) , microbiology and biotechnology , biology , biochemistry , chemistry , combinatorial chemistry
Objectives: Over the last decades, there has been a significant increase in antimicrobial prescribing and consumption associated with the development of patients' adverse events and antimicrobial resistance (AMR) to the point of becoming a global priority. This study aims at evaluating antibiotic prescribing during COVID-19 pandemic from November 2019 to December 2020. Materials and Methods: A systematic review was conducted primarily through the NCBI database, using PRISMA guidelines to identify relevant literature for the period between November 1, 2019 and December 19, 2020, using the keywords: COVID-19 OR SARS-Cov-2 AND antibiotics restricted to the English language excluding nonclinical articles. Five hundred twenty-seven titles were identified; all articles fulfilling the study criteria were included, 133 through the NCBI, and 8 through Google Scholar with a combined total of 141 studies. The patient's spectrum included all ages from neonates to elderly with all associated comorbidities, including immune suppression. Results: Of 28,093 patients included in the combined studies, 58.7% received antibiotics (16,490/28,093), ranging from 1.3% to 100% coverage. Antibiotics coverage was less in children (57%) than in adults with comorbidities (75%). Broad-spectrum antibiotics were prescribed presumptively without pathogen identifications, which might contribute to adverse outcomes. Conclusions: During the COVID-19 pandemic, there has been a significant and wide range of antibiotic prescribing in patients affected by the disease, particularly in adults with underlying comorbidities, despite the paucity of evidence of associated bacterial infections. The current practice might increase patients' immediate and long-term risks of adverse events, susceptibility to secondary infections as well as aggravating AMR.