Impact of COVID-19 on Outpatient Antimicrobial Prescribing Patterns in New York City

Douglas, Monica; Moy, Stanley; Hernandez, Nubriel

doi:10.1097/ipc.0000000000001071

Cited by 8 publications

(5 citation statements)

References 10 publications

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“…In particular, an interrupted time series analysis on outpatient antibiotic prescriptions in Ontario, Canada, showed a 31.2% (95% CI, 27.0–35.1%) reduction in total antibiotic prescriptions in outpatient settings during the COVID-19 pandemic driven by less antibiotic prescription for respiratory indications and largely explained by decreased visits for respiratory infections ( Kitano et al, 2021 ). Instead, some single-center retrospective chart reviews showed that during the first peak of COVID-19, in an area with high infection burden, there was an overall increase in antimicrobial prescription in outpatient primary care clinics ( Douglas et al, 2021 ). According to these preliminary results focused on the outpatient COVID-19-positive population, we attempted to investigate drugs included in the official positive or negative recommendations issued by national regulatory authorities.…”

Section: Discussionmentioning

confidence: 99%

Drug Prescriptions in the Outpatient Management of COVID-19: Evidence-Based Recommendations Versus Real Practice

Belleudi¹,

Finocchietti²,

Fortinguerra

et al. 2022

Front. Pharmacol.

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Background: Evidence-based recommendations for outpatient management of COVID-19 were published by the Italian Medicines Agency (AIFA) to limit the use of off-label treatments. The aim of this study is to measure the use of outpatient drug treatments in a COVID-19-positive population, taking into account the Italian regulatory agency’s advices.Methods: A descriptive observational study was conducted. All patients testing positive for COVID-19 residing in Lazio region, Italy, with diagnosis date between March 2020 and May 2021 were selected, and outpatient medicine prescription patterns were identified.Results: Independent of AIFA recommendations, the use of drug therapy in the management of outpatient COVID-19 cases was frequent (about one-third of the cases). The most used drug therapy was antibiotics, specifically azithromycin, despite the negative recommendation of AIFA, while the use of corticosteroids increased after the positive recommendation of regulatory agency for the use in subjects with severe COVID-19 disease. The use of hydroxychloroquine was limited to the early pandemic period where evidence on its potential benefit was controversial. Antithrombotics were widely used in outpatient settings, even if their use was recommended for hospitalized patients.Conclusion: In this study, we show a frequent use of drug therapy in the management of outpatient cases of COVID-19, mainly attributable to antibiotics use. Our research highlights the discrepancy between recommendations for care and clinical practice and the need for strategies to bridge gaps in evidence-informed decision-making.

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Section: Discussionmentioning

confidence: 99%

Drug Prescriptions in the Outpatient Management of COVID-19: Evidence-Based Recommendations Versus Real Practice

Belleudi¹,

Finocchietti²,

Fortinguerra

et al. 2022

Front. Pharmacol.

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“…This permitted identifying (1) patients who demonstrated sufficient clinical improvement for management outside the hospital, (2) patients with clinical deterioration for hospital admission and (3) those for whom therapy was deemed futile for selective hospital admission. 47 48 Severity of the disease can be estimated by symptom-complex phenotype (such as respiratory rate, oxygen saturation, blood pressure, heart rate, temperature, alertness), limited laboratory analysis (endotype: blood urea nitrogen, C-reactive protein) and demographics (age, sex). 49–53 …”

Section: Discussionmentioning

confidence: 99%

Evolution of serious and life-threatening COVID-19 pneumonia as the SARS-CoV-2 pandemic progressed: an observational study of mortality to 60 days after admission to a 15-hospital US health system

Murthy,

Gordon,

Lowry

et al. 2024

BMJ Open

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ObjectiveIn order to predict at hospital admission the prognosis of patients with serious and life-threatening COVID-19 pneumonia, we sought to understand the clinical characteristics of hospitalised patients at admission as the SARS-CoV-2 pandemic progressed, document their changing response to the virus and its variants over time, and identify factors most importantly associated with mortality after hospital admission.DesignObservational study using a prospective hospital systemwide COVID-19 database.Setting15-hospital US health system.Participants26 872 patients admitted with COVID-19 to our Northeast Ohio and Florida hospitals from 1 March 2020 to 1 June 2022.Main outcome measures60-day mortality (highest risk period) after hospital admission analysed by random survival forests machine learning using demographics, medical history, and COVID-19 vaccination status, and viral variant, symptoms, and routine laboratory test results obtained at hospital admission.ResultsHospital mortality fell from 11% in March 2020 to 3.7% in March 2022, a 66% decrease (p<0.0001); 60-day mortality fell from 17% in May 2020 to 4.7% in May 2022, a 72% decrease (p<0.0001). Advanced age was the strongest predictor of 60-day mortality, followed by admission laboratory test results. Risk-adjusted 60-day mortality had all patients been admitted in March 2020 was 15% (CI 3.0% to 28%), and had they all been admitted in May 2022, 12% (CI 2.2% to 23%), a 20% decrease (p<0.0001). Dissociation between observed and predicted decrease in mortality was related to temporal change in admission patient profile, particularly in laboratory test results, but not vaccination status or viral variant.ConclusionsHospital mortality from COVID-19 decreased substantially as the pandemic evolved but persisted after hospital discharge, eclipsing hospital mortality by 50% or more. However, after accounting for the many, even subtle, changes across the pandemic in patients’ demographics, medical history and particularly admission laboratory results, a patient admitted early in the pandemic and predicted to be at high risk would remain at high risk of mortality if admitted tomorrow.

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“…As an illustration, in the case of a chronic obstructive pulmonary disease (COPD) exacerbation or septic shock, as outlined in the surviving sepsis recommendations. (22) Plasma: The primary function of plasma is to facilitate the transportation of nutrients, hormones, and proteins to the specific regions of the body that require them. Additionally, cells expel their metabolic waste products into the plasma.…”

Section: ) Critical Casesmentioning

confidence: 99%

A Systemic Review on Covid 19

Harsha,

Sikdar,

Chinababu

et al. 2023

jchr

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Introduction:The coronavirus is a respiratory ailment that is characterised by its acute nature and is produced by a specific strain of coronavirus in the human population. This particular virus has the potential to induce severe symptoms and, in certain instances, lead to mortality, particularly among elderly individuals and those with pre-existing health disorders.. The emergence of the virus was first observed in China in 2019, and subsequently escalated into a global pandemic in 2020. The Corona Virus is classified as a positive-sense, single-stranded, non-segmented Ribose nucleic acid virus. It is a member of the Coronaviridae family within the Nidovirales order. This family has a wide range of viruses that can cause sickness in both animals and humans. The study includes different variants of covid-19 and various symptoms, they used different diagnostic methods to identify the covid-19, supportive care, vaccines, and medicines are under investigation. Aim: The main aim of this study was to investigate and provide insights into the pertinent clinical concerns and overview the health complication commonly observed in individuals who have diagnosed with covid-19. Methodology: Study design: Systematic review Study site: online databases like PubMed, Lancet, BMJ Study duration: November 2021-May 2022 Study sample: 30 articles were collected with key ideas Study criteria: Inclusion: • Studies performed on human subjects • Articles published in 2020-2022 • Manuscript titles like-covid-19, prescription patterns, treatment pattern, symptoms, systemic review, complications, first wave and second wave • Articles of Age group above 18 years • Articles published in countries like -

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Impact of COVID-19 on Outpatient Antimicrobial Prescribing Patterns in New York City

Cited by 8 publications

References 10 publications

Drug Prescriptions in the Outpatient Management of COVID-19: Evidence-Based Recommendations Versus Real Practice

Drug Prescriptions in the Outpatient Management of COVID-19: Evidence-Based Recommendations Versus Real Practice

Evolution of serious and life-threatening COVID-19 pneumonia as the SARS-CoV-2 pandemic progressed: an observational study of mortality to 60 days after admission to a 15-hospital US health system

A Systemic Review on Covid 19

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