Antibiotic misuse and compliance with infection control measures during COVID‐19 pandemic in community pharmacies in Egypt

Abstract

Background Globally, antibiotics misuse by the public has been reported in the era of COVID‐19, despite the discouraging instructions of the World Health Organization, especially for mild cases. Objective Is to describe this antibiotic misuse and its contributing factors. Also, to measure the pharmacists' application of infection preventive practices during the pandemic. Methods A cross‐sectional study was conducted among randomly selected Egyptian community pharmacists (Center, East, Delta, and Upper Egypt) using a questionnaire and direct interviews from 1 to 30 August 2020. The questionnaire consisted of two parts, the first covered pharmacist's demographic data and their application of basic infection preventive practices (eg, wearing face masks, regular hand sanitization, etc), and the other part was related to antibiotic dispensing patterns. Data were descriptively analyzed and the impact of participant experience on the responses was evaluated using the χ2 test. Results From 480 randomly selected Egyptian community pharmacists, 413 (87%) consented to participate in the study. 86.7% of the participants were keen to wear face masks (n = 358) and 86.2% kept regular hand sanitization (n = 356); whereas, 46.9% (n = 194) maintained adequate antibiotic stock supply during the pandemic. Nearly 67% (n = 275) of the pharmacists reported that patients were more likely to be given antibiotics for showing any sign or symptom of COVID‐19 infection, and 82% (n = 74 278) of the dispensed antibiotics were given upon physician recommendation. Azithromycin, Ceftriaxone, and Linezolid were the major antibiotics dispensed to COVID‐19 presumptive patients Azithromycin was given to ~40% of presumptive patients showing only mild or moderate symptoms for 5‐10 days. Additionally, antibiotic combinations were given to 74% (n = 62 479) of home‐isolated patients for a maximum of 2 weeks. Conclusions Pharmacists applied suitable sanitation and infection control protocols. Meanwhile, antibiotics were dispensed heavily during this pandemic without proper clinical indication and for long durations supporting the idea of antibiotic misuse.

Antibiotics Use and Its Knowledge in the Community: A Mobile Phone Survey during the COVID-19 Pandemic in Bangladesh

“…Yet, this study finding is much lower than 47% among the suspected COVID-19 cases reported in a previous hospital-based study from Bangladesh [ 20 ]. The proportion of antibiotics used for COVID-19 respondents in our study is also much lower than the study conducted in Egypt during the COVID-19 pandemic [ 17 ]. This may be likely to the fact that a very low number of COVID-19 cases were detected through this survey.…”

“…Still, 49% of the respondents reported that antibiotics were effective against bacterial infection only [ 16 ]. Dispensing of antibiotics was increased profoundly in Egypt during the early period of the COVID-19 pandemic without proper clinical evaluation, and azithromycin, ceftriaxone, and linezolid were the major antibiotics used [ 17 ]. Approximately, 93% of the presumptive COVID-19 patients received antibiotics with official prescriptions and without prescriptions, of which 18% comprised of pharmacist and patient’s recommendations [ 17 ].…”

“…Dispensing of antibiotics was increased profoundly in Egypt during the early period of the COVID-19 pandemic without proper clinical evaluation, and azithromycin, ceftriaxone, and linezolid were the major antibiotics used [ 17 ]. Approximately, 93% of the presumptive COVID-19 patients received antibiotics with official prescriptions and without prescriptions, of which 18% comprised of pharmacist and patient’s recommendations [ 17 ]. Before the COVID-19 pandemic, studies in Bangladesh reported that 48% of adult respondents heard about antibiotics, 70% of children of those parents who were aware of antibiotics had received it previously, and 28% of study participants took antibiotics before presenting at the hospital for acute febrile illness [ 18 , 19 ].…”

Combinations of drugs might increase the survival chances of COVID-19 patients: Literature review till date

“…2. Abuse of Antibiotics has been reported to be a key factor in worsening/aggravating the diseased condition in COVID-19 patients [2082,2083,2084,2085].…”

Live Biosensors for Ultrahigh-Throughput Screening of Antimicrobial Activity against Gram-Negative Bacteria

“…AMR represents a threat to sustainable development, leading to 11 million deaths annually [1,2]. The recent COVID-19 pandemic resulted in a significant increase in antibiotic sales [3] and extensive antibiotic use without proper clinical indication [4]. Hence, the overuse of antibiotics lays the foundations for further resistome propagation and multi-resistance evolution.…”