Outpatient antibiotic prescribing down considerably in 2020

Key takeaways:

• Total outpatient antibiotic prescribing fell 26.8% in 2020.
• Face masks and college closures had been related to fewer antibiotic prescriptions amongst kids, suggesting NPIs could have contributed to reductions of different higher respiratory infections.

Outpatient antibiotic prescribing fell greater than 25% in 2020 in contrast with earlier years throughout all ages, however researchers discovered a lot of the prescribing was amongst adults, in keeping with a examine revealed in Open Discussion board Infectious Illnesses.

“Inappropriate prescribing of antibiotics for viral higher respiratory infections was frequent pre-pandemic, and we wished to see if information indicated will increase in COVID-19 circumstances, usually presenting with higher respiratory signs, had been related to will increase in outpatient antibiotic prescribing,” Alisa Hamilton, MS, senior analysis analyst on the One Well being Belief, informed Healio.

“We had been additionally curious in regards to the influence of nonpharmaceutical interventions (NPIs) on prescribing. Prevention measures, akin to sporting masks and shutting colleges, may have decreased transmission of different higher respiratory infections, which, in flip, may have led to reductions in prescribing,” Hamilton stated.

To evaluate the general influence of COVID-19 circumstances on antibiotic prescribing, Hamilton and colleagues performed an ecological examine utilizing random results panel regression of month-to-month reported COVID-19 county case and antibiotic prescription information. In keeping with the examine, they evaluated for seasonality, urbanicity, well being care entry NPIs, and sociodemographic elements.

Complete outpatient antibiotic prescribing fell 26.8% between March and December 2020 in contrast with the identical interval lately. Traits in prescribing confirmed that prescriptions fell “considerably” between April and Could 2020, rebounded in June and July, and remained beneath common by the remainder of the yr.

When assessing particular antibiotics, the examine confirmed that general prescribing of Quinolones dropped 28.9% from a imply of 6,738.3 prescriptions per 100,000 in earlier years to 4,787.1 per 100,000 in 2020, whereas tetracyclines dropped 3.13% and different antibiotics confirmed “negligible modifications.”

When assessed at a county stage, the researchers discovered that every 1% enhance in COVID-19 circumstances was related to a 0.009% (95% CI, 0.007%-0.012%) enhance in prescriptions per 100,000 inhabitants allotted to all ages and a 0.012% (95% CI, –0.017% to –0.008%) lower in prescriptions per 100,000 kids.

Additional subanalyses assessing kids particularly confirmed that counties with colleges conducting in-person studying had been related to a 0.044% (95% CI, 0.024%-0.065%) enhance in prescriptions per 100,000 kids in contrast with counties that closed colleges.

The researchers additionally discovered different elements related to decrease prescribing amongst kids, together with “inside motion restrictions” and college closures (–0.03%; 95% CI, –0.047% to –0.013%) and requiring face masks (0.029%; 95% CI, –0.054% to –0.004%).

“We are able to study rather a lot from historic COVID-19 information relating to antibiotic prescribing, which can assist in planning for seasonal epidemics and designing antimicrobial stewardship packages,” Hamilton stated. “Provided that prescribing norms seem to cluster on the state stage, contemplating cultural variations and tailoring antimicrobial stewardship packages to native contexts are possible key parts of their success.”