Antimicrobial stewardship: a COVID casualty?

Lynch, Chris; Mahida, Nikunj; Gray, Jim

doi:10.1016/j.jhin.2020.10.002

Cited by 42 publications

(40 citation statements)

References 23 publications

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“…Recently, Lynch et al suggested that “AMS has become a casualty of the COVID-19 pandemic” [ 24 ]. In this survey we highlighted that while routine AMS activities were indeed a casualty of the COVID-19 pandemic, there were some opportunities presented and some positive outcomes.…”

Section: Resultsmentioning

confidence: 99%

Assessing the Impact of COVID-19 on Antimicrobial Stewardship Activities/Programs in the United Kingdom

et al. 2021

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Since first identified in late 2019, the acute respiratory syndrome coronavirus (SARS-CoV2) and the resulting coronavirus disease (COVID-19) pandemic has overwhelmed healthcare systems worldwide, often diverting key resources in a bid to meet unprecedented challenges. To measure its impact on national antimicrobial stewardship (AMS) activities, a questionnaire was designed and disseminated to antimicrobialstewardship leads in the United Kingdom (UK). Most respondents reported a reduction in AMS activity with 64% (61/95) reporting that COVID-19 had a negative impact on routine AMS activities. Activities reported to have been negatively affected by the pandemic include audit, quality improvement initiatives, education, AMS meetings, and multidisciplinary working including ward rounds. However, positive outcomes were also identified, with technology being increasingly used as a tool to facilitate stewardship, e.g., virtual meetings and ward rounds and increased the acceptance of using procalcitonin tests to distinguish between viral and bacterial infections. The COVID-19 pandemic has had a significant impact on the AMS activities undertaken across the UK. The long-term impact of the reduced AMS activities on incidence of AMR are not yet known. The legacy of innovation, use of technology, and increased collaboration from the pandemic could strengthen AMS in the post-pandemic era and presents opportunities for further development of AMS.

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Section: Resultsmentioning

confidence: 99%

Assessing the Impact of COVID-19 on Antimicrobial Stewardship Activities/Programs in the United Kingdom

et al. 2021

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“…Early anecdotal evidence from two acute care facilities in New York and Missouri reported three- to fourfold increases in central line-associated bloodstream infection rates, likely related to a shift towards a higher risk case-mix ( McMullen et al, 2020 ). The hardships and resource strains due to COVID-19 have also affected antimicrobial stewardship activities ( Hsu, 2020 ; De Waele et al, 2021 ; Ginsburg and Klugman, 2020 ; Lynch et al, 2020 ; Seaton, 2020 ). It is known that antimicrobial stewardship programmes in hospitals have the potential to significantly reduce incidence of infections with ARO ( Baur et al, 2017 ), with the main aim being to minimise the risk of antibiotic misuse leading to AMR.…”

Section: Covid-19 Impact On Amrmentioning

confidence: 99%

Antimicrobial resistance and COVID-19: Intersections and implications

Knight

Glover

McQuaid

et al. 2021

eLife

259

212

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Before the coronavirus 2019 (COVID-19) pandemic began, antimicrobial resistance (AMR) was among the top priorities for global public health. Already a complex challenge, AMR now needs to be addressed in a changing healthcare landscape. Here, we analyse how changes due to COVID-19 in terms of antimicrobial usage, infection prevention, and health systems affect the emergence, transmission, and burden of AMR. Increased hand hygiene, decreased international travel, and decreased elective hospital procedures may reduce AMR pathogen selection and spread in the short term. However, the opposite effects may be seen if antibiotics are more widely used as standard healthcare pathways break down. Over 6 months into the COVID-19 pandemic, the dynamics of AMR remain uncertain. We call for the AMR community to keep a global perspective while designing finely tuned surveillance and research to continue to improve our preparedness and response to these intersecting public health challenges.

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“…Although the early data suggested low rates of coinfection with COVID-19, there is an indiscriminate use of antimicrobials present indicating that antimicrobial stewardship may be another casualty of the COVID-19 pandemic [ 16 , 17 ]. The utilization of established antibiotic stewardship programs has plummeted as healthcare workers struggle to save lives of patients with COVID-19 and are even asked to prioritize COVID-19 response and management [ 16 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

Implications of COVID-19 Pandemic on the Emergence of Antimicrobial Resistance: Adjusting the Response to Future Outbreaks

Rušić

Vilović

Bukic

et al. 2021

Life

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The net effect of the coronavirus disease 2019 (COVID-19) pandemic and the response to it on the emergence of antimicrobial resistance is yet unknown. Positive impacts on the spread of multiresistant pathogens and infections in general may be observed with the implementation of general preventative measures for the spread of infectious disease such as social distancing, reduced travel and increased personal hygiene. This pandemic has accelerated the development of novel technologies, such as mRNA vaccines, that may be used to fight other diseases. These should be capitalized upon to manage the ongoing antimicrobial resistance pandemic in the background. However, it is likely that the COVID-19 pandemic is fueling the emergence of antimicrobial resistance due to high rates of inappropriate antimicrobial prescribing, the high use of biocides and the interruption of treatment for other conditions. Clinical uncertainty driven by the lack of effective diagnostics and practice of telemedicine may have driven the inappropriate use of antimicrobials. As pathogens know no borders, increased focus is needed for infectious diseases still threatening low- and middle-income countries such as tuberculosis. Stewardship measures for future outbreaks should stress the importance of social distancing and hand washing but discourage the overuse of disinfectants and antimicrobials that are not proven effective.

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Antimicrobial stewardship: a COVID casualty?

Cited by 42 publications

References 23 publications

Assessing the Impact of COVID-19 on Antimicrobial Stewardship Activities/Programs in the United Kingdom

Assessing the Impact of COVID-19 on Antimicrobial Stewardship Activities/Programs in the United Kingdom

Antimicrobial resistance and COVID-19: Intersections and implications

Implications of COVID-19 Pandemic on the Emergence of Antimicrobial Resistance: Adjusting the Response to Future Outbreaks

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