Prevalence of antibiotics prescription amongst patients with and without COVID-19 in low- and middle-income countries: a systematic review and meta-analysis

Satria, Yohanes Aditya Adhi; Utami, Monica Suci; Prasudi, Alexander

doi:10.1080/20477724.2022.2160892

Cited by 6 publications

(4 citation statements)

References 83 publications

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“…More than two-thirds of the total patient encounters in our study were supplied with at least one antimicrobial, with nearly three-quarters of these being antibiotics. This overuse of antibiotics in ambulatory care during the COVID-19 pandemic is in line with previous studies from other South Asian countries and beyond [ 62 , 63 , 64 , 65 ]. A recent study analyzing sales data from 71 countries also concluded similar findings, with an increase in antibiotic utilization during the COVID-19 pandemic [ 66 ].…”

Section: Discussionsupporting

confidence: 91%

Antimicrobial Dispensing Practices during COVID-19 and the Implications for Pakistan

Gul¹,

Sana

Saleem

et al. 2023

Antibiotics

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Antibiotics are one of the most frequently dispensed classes of medicines. However, excessive misuse and abuse enhances antimicrobial resistance (AMR). Previous studies in Pakistan have documented extensive dispensing of ‘Watch’ and ‘Reserve’ antibiotics, which is a concern. In view of this, there is a need to assess current dispensing patterns following COVID-19 in Pakistan. A cross-sectional study was undertaken, collecting dispensing data from 39 pharmacies and 53 drug stores from November 2022 to February 2023. Outlets were principally in urban areas (60.9%), with pharmacists/pharmacy technicians present in 32.6% of outlets. In total, 11,092 prescriptions were analyzed; 67.1% of patients were supplied at least one antimicrobial, 74.3% antibiotics, 10.2% antifungals and 7.9% anthelmintics. A total of 33.2% of antimicrobials were supplied without a prescription. Common indications for dispensed antibiotics were respiratory (34.3%) and gastrointestinal (16.8%) infections, which can be self-limiting. In addition, 12% of antibiotics were dispensed for the prevention or treatment of COVID-19. The most frequent antibiotics dispensed were ceftriaxone (18.4%) and amoxicillin (15.4%). Overall, 59.2% antibiotics were ‘Watch’ antibiotics, followed by ‘Access’ (40.3%) and ‘Reserve’ (0.5%) antibiotics. Of the total antibiotics dispensed for treating COVID-19, 68.3% were ‘Watch’ and 31.7% ‘Access’. Overall, there appeared to be an appreciable number of antibiotics dispensed during the recent pandemic, including for patients with COVID-19, alongside generally extensive dispensing of ‘Watch’ antibiotics. This needs to be urgently addressed with appropriate programs among pharmacists/pharmacy technicians to reduce AMR.

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Section: Discussionsupporting

confidence: 91%

Antimicrobial Dispensing Practices during COVID-19 and the Implications for Pakistan

Gul¹,

Sana

Saleem

et al. 2023

Antibiotics

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“…The consequences include the disruption of early diagnosis and management of patients with cancer, as well as severe effects on the routine follow-up of patients with cardiovascular disease, including diabetes [ 75 , 78 , 79 , 80 ]. Alongside this, there have been high rates of inappropriate prescribing of antibiotics among patients with COVID-19 across LMICs fueling antimicrobial resistance (AMR), which is already a considerable concern across Africa [ 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 ]. Consequently, it is vital that patients across Africa are fully vaccinated to reduce the consequences of COVID-19, as well as the unintended consequences, which have occurred as a result of a variety of measures introduced to reduce the spread of the disease in the absence of effective vaccines and treatments.…”

Section: Introductionmentioning

confidence: 99%

COVID-19 Vaccine Acceptance and Hesitancy among Healthcare Workers in Lusaka, Zambia; Findings and Implications for the Future

Mudenda,

Daka,

Matafwali

et al. 2023

Vaccines

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The uptake of COVID-19 vaccines is critical to address the severe consequences of the disease. Previous studies have suggested that many healthcare workers (HCWs) are hesitant to receive the COVID-19 vaccine, further enhancing hesitancy rates within countries. COVID-19 vaccine acceptance and hesitancy levels are currently unknown among HCWs in Zambia, which is a concern given the burden of infectious diseases in the country. Consequently, this study assessed COVID-19 vaccine acceptance and hesitancy among HCWs in Lusaka, Zambia. A cross-sectional study was conducted among 240 HCWs between August and September 2022, using a semi-structured questionnaire. Multivariable analysis was used to determine the key factors associated with vaccine hesitancy among HCWs. Of the 240 HCWs who participated, 54.2% were females. A total of 72.1% of the HCWs would accept being vaccinated, while 27.9% were hesitant. Moreover, 93.3% of HCWs had positive attitudes towards COVID-19 vaccines, with medical doctors having the highest mean attitude score (82%). Encouragingly, HCWs with positive attitudes towards COVID-19 vaccines had reduced odds of being hesitant (AOR = 0.02, 95% CI: 0.01–0.11, p < 0.001). Overall, acceptance of the COVID-19 vaccine among HCWs in Lusaka, Zambia, was high, especially by those with positive attitudes. However, the current hesitancy among some HCWs is a concern. Consequently, there is a need to address this and encourage HCWs to fully promote vaccination programs going forward.

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“…Evidence indicates that antibiotics were over and unnecessarily prescribed during the first waves of the COVID-19 pandemic [6][7][8][9]. Although this was found to be greater in some LMICs [10][11][12][13], studies on the impact of COVID-19 in LMICs are scarce. Research globally suggests that the prescribing of antibiotics may have been far higher than the prevalence of secondary bacterial infections and co-infections may have been necessitated [11,[14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

The Impact of COVID-19 on Knowledge, Beliefs, and Practices of Ni-Vanuatu Health Workers Regarding Antibiotic Prescribing and Antibiotic Resistance, 2018 and 2022: A Mixed Methods Study

Foxlee,

Taleo,

Mathias

et al. 2023

TropicalMed

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Antimicrobial resistance (AMR) is included in the ten most urgent global public health threats. Global evidence suggests that antibiotics were over prescribed during the early waves of the COVID-19 pandemic, particularly in low- and middle-income countries. Inappropriate use of antibiotics drives the emergence and spread of antibiotic resistance. This study aimed to examine the impact of COVID-19 on Ni-Vanuatu health worker knowledge, beliefs, and practices (KBP) regarding antibiotic prescribing and awareness of antibacterial AMR. A mixed methods study was conducted using questionnaires and in-depth interviews in 2018 and 2022. A total of 49 respondents completed both baseline (2018) and follow-up (2022) questionnaires. Knowledge scores about prescribing improved between surveys, although health workers were less confident about some prescribing activities. Respondents identified barriers to optimal hand hygiene performance. More than three-quarters of respondents reported that COVID-19 influenced their prescribing practice and heightened their awareness of ABR: “more careful”, “more aware”, “stricter”, and “need more community awareness”. Recommendations include providing ongoing continuing professional development to improve knowledge, enhance skills, and maintain prescribing competency; formalising antibiotic stewardship and infection, prevention, and control (IPC) programmes to optimise prescribing and IPC practices; and raising community awareness about ABR to support more effective use of medications.

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Prevalence of antibiotics prescription amongst patients with and without COVID-19 in low- and middle-income countries: a systematic review and meta-analysis

Cited by 6 publications

References 83 publications

Antimicrobial Dispensing Practices during COVID-19 and the Implications for Pakistan

Antimicrobial Dispensing Practices during COVID-19 and the Implications for Pakistan

COVID-19 Vaccine Acceptance and Hesitancy among Healthcare Workers in Lusaka, Zambia; Findings and Implications for the Future

The Impact of COVID-19 on Knowledge, Beliefs, and Practices of Ni-Vanuatu Health Workers Regarding Antibiotic Prescribing and Antibiotic Resistance, 2018 and 2022: A Mixed Methods Study

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