Infectious Disease

Fillings for 10 of the commonest antibiotics dropped as a lot as 56% within the early days of the pandemic

January 07, 2021

2 min read

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Disclosure:
Clancy reports numerous connections to industry. In the study you will find all relevant financial information from all other authors.

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Prescription fillings for each of the top 10 most prescribed ambulatory antibiotics in the United States declined by up to 56% in April during the first peak of the COVID-19 pandemic.

By July, seven antibiotics had recovered. However, fillings for azithromycin, amoxicillin clavulanate, and levofloxacin, which are typically used for bacterial lower and upper respiratory infections, did not return to seasonally adjusted prepandemic levels.

Antibiotics

Prescription fillings for the top 10 most prescribed ambulatory antibiotics in the U.S. declined 13% to 56% in April 2020 during the first peak of the COVID-19 pandemic.
Photo credit: Adobe Stock

“We previously published a paper on the impact of COVID-19 on hospital antibiotic prescribing and administration in our healthcare system. We saw a significant decrease in total antibiotic use in the first few months of the pandemic, but an increase in use per bed-care day. ” Cornelius (Neil) J. Clancy, MD, said Healio, associate professor of medicine and director of the Comprehensive Drug Resistant Pathogen Laboratory and Mycology Program at the University of Pittsburgh.

“The impact of this use on antibiotic resistance remains unclear,” said Clancy. “The outpatient use of antibiotics dwarfs the use in hospitals and is a major driver of resistance in a certain geographic region. We hypothesized that a sharp drop in ambulatory prescriptions in the early stages of the U.S. pandemic would be offset by later setbacks. “

Cornelius (Neil) J. Clancy

Clancy and colleagues received monthly prescription data for August 2014 through July 2020 from the IQVIA National Prescription Audit databases. According to the study, the researchers then used models to estimate changes in fillings from August 2014 to March 2020 and April 2020 to July 2020 “to control past trends and autocorrelations (seasonal effects)”.

According to the study, which rated monthly prescription fillings per 1,000 people, there were significant decreases in fillings for ciprofloxacin (P <0.001), levofloxacin (P <0.001), sulfamethoxazole-trimethoprim (P <) during prepandemic. 001) and clindamycin (P = 0.006) as well as a significant increase in the monthly fillings per 1,000 people doxycycline and nitrofurantoin (P <0.001). No significant changes were observed for amoxicillin, azithromycin, amoxicillin clavulanate, or cephalexin.

According to the study, monthly prescription fillings per 1,000 people for all 10 antibiotics decreased significantly in April, by at least 13% (for nitrofurantoin) and as much as 56% (for amoxicillin) (P <0.001).

Then from April to July there were no significant changes in the monthly prescriptions of azithromycin, amoxicillin clavulanate, or levofloxacin, while the monthly fillings of other antibiotics increased significantly (P <0.001) during these months, Clancy and colleagues reported.

“COVID-19 has had an immediate and ongoing impact on the use of ambulatory antibiotics in the United States, particularly drugs used to treat respiratory infections,” Clancy said. “The reasons for this are unclear, but may indicate that patients are less likely to treat respiratory problems, doctors are less likely to prescribe antibiotics for respiratory problems, and / or preventive measures have resulted in fewer respiratory infections compared to COVID-19. ”

“As unnecessary antibiotic prescriptions may have decreased,” Clancy said, “changing their usage could provide a basis for management to build on.” It will be important to understand the reasons for prescribing behaviors and how patterns develop during the COVID-19 waves of late fall and winter in the United States. “

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