Introduction and Aim: One of the main goals of the World Health Organization (WHO) global action plan to combat Antimicrobial Resistance is to study the tendency of antimicrobial consumption for systemic use to improve how antimicrobial medications are prescribed and utilized. The objective of the study was to evaluate antibiotic use based on the WHO Access, Watch, Reserve (AWaRe) classification and analyse antimicrobial consumption using Defined Daily Doses in a multidisciplinary hospital in Bishkek, Kyrgyzstan, between 2016 and 2019. Materials and Methods: A retrospective longitudinal analysis of antimicrobial consumption data from a multidisciplinary hospital in Bishkek, Kyrgyzstan, was completed between 2016 and 2019. Information on the structure and volume of antimicrobial consumption, and the number of bed days, was obtained from the internal database and official annual reports of the multidisciplinary hospital. Results: The consumption of levofloxacin increased by 3.935 Defined Daily Doses per 100 Bed-Days (DDD/100BD) (5.6 times) and that of moxifloxacin by 450 DDD/100BD (10.1 times), compared to that in 2016. Notably, the analysis of data on DDD/100BD consumption based on antimicrobial groups identified the most frequently used medications as stationary data points and identified the top-assigned antimicrobials from different groups, which increased in consumption over time. Conclusion: The rapid growth in the use of antibiotics from the Watch class, particularly in low- and middle-income countries, reflects the challenges associated with the rational use of antibiotics. The AWaRe system is an important indicator of efforts to combat Antimicrobial Resistance and ensure equal access to effective antibiotics worldwide.

Introduction and Aim: We examined the effect of pre- and/or post-infection doxycycline on human nasal epithelial cell viability and SARS-CoV-2 (clinical strain IHUMI-3) replication in vitro.  Materials and Methods: Human nasal epithelial cells, an in vivo SARS-CoV-2 target, were derived from healthy donor nasal epithelial stem/progenitor cells via in vitro differentiation. The cells were exposed to doxycycline at 0, 0.1, 0.5, 1, 5, 10, 50, and 100 ?M before and/or after IHUMI-3 inoculation to determine the optimal inhibitory concentration. Viral replication was evaluated using quantitative reverse-transcription PCR, and doxycycline 50% cytotoxic concentration (CC50) and half-maximal effective concentration (EC50) were calculated. The peak serum concentration (Cmax) resulting from typical oral (100 or 200 mg) or intravenous (100 mg) doxycycline doses was estimated, and the Cmax/EC50 ratio was calculated as an index of potential clinical utility.  Results: Doxycycline exhibited low cytotoxicity (CC50 > 100 ?M) in human nasal epithelial cells and inhibited SARS-CoV-2 replication (EC50: 5.2 ± 3.3 ?M) in a dose-dependent manner when administered pre- and/or post-infection. Reasonable oral or intravenous doses will help achieve effective concentrations in vivo.  Conclusion: Early administration of this well-characterized, safe, and accessible drug may limit person-to-person transmission and prevent progression to severe coronavirus disease.

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