Antibiotic guidelines for COVID patients linked to reduced prescribing
Guidelines for antibiotic initiation and discontinuation for community-acquired bacterial pneumonia (CABP) in COVID-19 patients at a Chicago hospital were associated with reduced antibiotic prescribing and days of therapy (DOT), researchers reported yesterday in BMC Infectious Diseases.
Researchers at University of Chicago Medicine evaluated the duration of antibiotic therapy from Mar 1 to Apr 25, 2020, in COVID-19 patients who received at least one antibiotic for CABP before and after the Mar 28 implementation of the guidelines, which were developed by the hospital’s antimicrobial stewardship program in conjunction with infectious diseases providers. Indications to initiate empiric antibiotics included the presence of leukocytosis, fever, or chest imaging suggestive of a bacterial infections. The researchers also assessed the rate of patients receiving empiric antibiotics, hospital length-0f-stay, 30-day readmissions, and in-hospital mortality.
The retrospective study involved 506 patients, with 102 in the pre-intervention period and 404 in the post-intervention period. Prior to the guidelines, 74.5% of patients with COVID-19 received antibiotics, compared with 42% after implementation of the guidelines. The median DOT in the post-intervention group was 1.3 days shorter than the pre-intervention group, and the DOT of antibiotics directed at atypical bacteria was reduced by 2.8 days. In addition, more patients in the post-intervention group were initiated on empiric antibiotics based on criteria consistent with the guidelines (68% vs 87%). No differences in clinical outcomes were observed between the two groups.
“To our knowledge, this is the first report of an antimicrobial stewardship intervention to reduce the prescribing of empiric antibiotics for CABP in COVID-19 patients,” the study authors wrote. “Reductions in antibiotic use have important implications and can potentially reduce antimicrobial resistance and antibiotic-related toxicities.”
The authors add that further studies are needed to examine the potential clinical impact of stewardship interventions targeting antibiotic prescribing for CABP in COVID-19 patients.
Jun 2 BMC Infect Dis study
UK government to invest in antibiotic development, improved access
The British government today announced a £1 million ($1.4 million USD) investment to help the Global Antibiotic Research and Development Partnership’s (GARDP’s) efforts to develop and expand access to treatments for drug-resistant infections.
The money from the Global Antimicrobial Resistance Innovation Fund, part of the UK Department of Health and Social Care (DHSC), will support GARDP’s pipeline of new antibiotics and contribute to the development of SECURE, a new antibiotics initiative from GARDP and the World Health Organization. SECURE’s mission is to expand global access to new antibiotics that treat drug-resistant infections and to existing antibiotics that are not widely available or suffer from supply-chain disruptions or shortages.
“We are extremely pleased by the UK’s increased contribution at a time when COVID-19 has demonstrated the critical importance of preventing and preparing for pandemics, including the pandemic of drug-resistant infections,” GARDP Director of Research and Development Seamus O’Brien, PhD, said in a DHSC press release. “By investing an additional £1 million, the UK is again demonstrating leadership in efforts to accelerate the development and delivery of life-changing and life-saving treatments for every person who needs them.”
The UK government to date has committed £13 million to GARDP.
Jun 3 DHSC press release