Drug Repurposing and Observational Studies: The Case of Antivirals for the Treatment of COVID-19

Hernán, Miguel A.; Amo, Julia del

doi:10.7326/m22-3582

Cited by 4 publications

(1 citation statement)

References 33 publications

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“… 54 , 55 Several antiviral drugs were repurposed for the treatment of COVID-19 including remdesivir, molnupiravir and tenofovir. 56 Other drugs were part of clinical trials, such as hydroxychloroquine and lopinavir/ritonavir but were withheld from the guidelines due to lack of evidence for effectiveness. 57 Remdesivir was effective in reducing hospitalization rates and mortality among patients with COVID-19 and was reserved for patients with severe disease who were hospitalized.…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial consumption in an acute NHS Trust during the COVID-19 pandemic: intervention time series analysis

Khan,

Bond,

Lee-Milner

et al. 2023

JAC-Antimicrobial Resistance

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Objective To determine the impact of the COVID-19 pandemic on antimicrobial consumption and trends of therapeutic drugs for COVID-19 treatments, including corticosteroids, remdesivir and monoclonal antibodies (tocilizumab) from April 2017 to September 2022 in a secondary care NHS Trust in England. Methods A retrospective intervention time series analysis was conducted for April 2017 to September 2022 at the Mid Yorkshire Teaching NHS Trust. Data were retrieved from the pharmacy dispensing system as defined daily doses (DDDs) monthly and reported per 1000 occupied bed days (OBDs). Antimicrobial consumption and COVID-19 treatment options were measured. DDDs were calculated according to the classification of antimicrobials for systemic use (J01) and for other drugs classification. Trends for antimicrobial consumption and other therapeutic drugs for treating COVID-19 were also determined in each wave in England. Results During the pandemic: total antibiotic consumption decreased from 826.4 to 728.2 DDDs per 1000 OBDs (P = 0.0067); piperacillin/tazobactam use increased (P < 0.0001) and ciprofloxacin use decreased (P < 0.0001); there were no changes in Access, Watch, Reserve antibiotic use, and the proportion of antifungal consumption was consistent throughout the study. The use of total antibiotics (P = 0.024), levofloxacin (P = 0.0007), piperacillin/tazobactam (P = 0.0015) and co-amoxiclav (P = 0.0198) increased during wave one. Consumption of COVID-19 treatment drugs was highest during wave two, with 624.3 DDDs per 1000 OBDs for dexamethasone (P = 0.4441), 6.8 DDDs per 1000 OBDs for remdesivir (P < 0.0001) and 35.01 DDDs per 1000 OBDs for tocilizumab (P = 0.2544). Discussion This study determined the consumption of antimicrobials trends before and during the pandemic. The individual wave antimicrobial consumption indicates maximum consumption in the first wave, advocating for antimicrobial stewardship and preparedness for future pandemics.

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