COVID-19 pandemics and antibiotics use in the University Clinical Centre of Kosova
Main Article Content
Keywords
antimicrobial consumption, antimicrobial resistance, university clinical centre of kosova
Abstract
Background: One profoundly consequential facet of Kosovo healthcare pertains to antimicrobial drug consumption. The absence of specific guidelines for antimicrobial usage in the context of COVID-19 resulted in a notable upswing in antibiotic consumption across the country. This surge in antibiotic usage is particularly disconcerting within hospital settings, where the risk of antibiotic-resistant infections becomes significantly more pronounced. Objectives: To address this concern, this paper endeavors to undertake a comprehensive analysis of antibiotic consumption within hospital facilities over the years 2020, 2021, and 2022. This analysis will juxtapose antibiotic consumption during these years against the general population and preceding years. Results: The findings from the clinical center reveal a substantial upsurge in the consumption of most antibiotics during 2021, followed by a subsequent decline in 2022. However, a wealth of data underscores the notable utilization of ceftriaxone, exhibiting an annual increase of 32%, and imipenem, showing an annual increase of 47%. Similar upward trends were observed with other antibiotics in this research following the consumption in the first year of the COVID-19 pandemic. Conclusion: Preserving patient safety and promoting rational antibiotic use necessitates heightened monitoring and strengthening antimicrobial stewardship initiatives. Moreover, antimicrobial stewardship measures must be enhanced and consistently maintained to ensure the prudent utilization of antibiotics throughout the pandemic.
References
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antibiotics10060690
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2nd Interim guidance. 2020. Available: https://canadiancriticalcare.org/resources/Documents/AMMI-CCCS-PHAC-clinicalguidance-Aug21-EN-FINAL.pdf Accessed: 8 November 2022.
22. Brogan DM, Mossialos E. A critical analysis of the review on antimicrobial resistance report and the infectious disease financing facility. Global health. 2016;12:1-7. https://doi.org/10.1186/s12992-016-0147-y
23. Khor WP, Olaoye O, D’Arcy N, Krockow EM, Elshenawy RA, Rutter V, et al. The need for ongoing antimicrobial stewardship
during the COVID-19 pandemic and actionable recommendations. Antibiotics. 2020;9(12):904. https://doi.org/10.3390/antibiotics9120904
24. Sofy MR, Mancy AG, Alnaggar AEAM, Refaey EE, Mohamed HI, Elnosary ME, et al. A polishing the harmful effects of broad bean mottle virus infecting broad bean plants by enhancing the immunity using different potassium concentrations. Notulae Botanicae Horti Agrobotanici Cluj-Napoca. 2022;50:12654.
25. Alanio A, Dellière S, Fodil S, Bretagne S, Mégarbane B. Prevalence of putative invasive pulmonary aspergillosis in critically ill patients with COVID-19. Lancet Respir Med. 2020;8:e48-e49. https://doi.org/10.1016/s2213-2600(20)30237-x
26. Arshad S, Kilgore P, Chaudhry ZS, Jacobsen G, Wang DD, Huitsing K, et al. Treatment with hydroxychloroquine, azithromycin, and combination in patients hospitalized with COVID-19. International Journal of Infectious Diseases. 2020;97:396-403. https://doi.org/10.1016/j.ijid.2020.06.099
27. King LM, Lovegrove MC, Shehab N, Tsay S, Budnitz DS, Geller AI, et al. Trends in US outpatient antibiotic prescriptions during the coronavirus disease 2019 pandemic. Clin Infect Dis. 2021;73(3):e652-e660. https://doi.org/10.1093/cid/ciaa1896
28. De Lusignan S, Joy M, Sherlock J, Tripathy M, van Hecke O, Gbinigie O, et al. Principle trial demonstrates scope for in-pandemic primary care antibiotic stewardship improvement. medRxiv. 2021;5(5):21250902. https://doi.org/10.3399/bjgpo.2021.0087
29. Liew Y, Lee WHL, Tan L, Kwa ALH, Thien SY, Cherng BPZ, et al. Antimicrobial stewardship programme: a vital resource for hospitals during the global coronavirus disease 2019 (COVID-19) outbreak. Int J Antimicrob Agents. 2020;56:106145. https://doi.org/10.1016/j.ijantimicag.2020.106145
30. Tran DH, Sugamata R, Hirose T, Suzuki S, Noguchi Y, Sugawara A, et al. Azithromycin, a 15-membered macrolide antibiotic, inhibits influenza A(H1N1)pdm09 virus infection by interfering with virus internalization process. J Antibiot. 2019;72(10):759-768. https://doi.org/10.1038/s41429-019-0204-x
31. Gibson PG, Yang IA, Upham JW, Reynolds PN, Hodge S, James AL, et al. Effect of azithromycin on asthma exacerbations and quality of life in adults with persistent uncontrolled asthma (AMAZES): a randomized, double-blind, placebo-controlled trial. Lancet. 2017;390(10095):659-68. https://doi.org/10.1016/s0140-6736(17)31281-3
32. Hinks TSC, Cureton L, Knight R, Wang A, Cane JL, Barber VS, et al. Azithromycin versus standard care in patients with mildto-moderate COVID-19 (ATOMIC2): an open-label, randomized trial. Lancet Respir Med. 2021;9(10):1130-40. https://doi.org/10.1016/s2213-2600(21)00263-0
33. Hinks TSC, Cureton L, Knight R, Wang A, Cane JL, Barber VS, et al. Azithromycin versus standard care in patients with mildto-moderate COVID-19 (ATOMIC2): an open-label, randomized trial. Lancet Respir Med. 2021;9(10):1130-40. https://doi.org/10.1016/s2213-2600(21)00263-0
34. Badawy IH, Hmed AA, Sofy MR, Al-Mokadem AZ. Alleviation of cadmium and nickel toxicity and phyto-stimulation of tomato plant by endophytic Micrococcus luteus and Enterobacter cloacae. Plants. 2022;11(15):2018. https://doi.org/10.3390/plants11152018
35. Grau S, Echeverria-Esnal D, Gómez-Zorrilla S, Navarrete-Rouco ME, Masclans JR, Espona M, et al. Evolution of antimicrobial consumption during the first wave of COVID-19 pandemic. Antibiotics. 2021;10(2):132. https://doi.org/10.3390/antibiotics10020132
36. HamİDİ AA, Yilmaz Ş. Antibiotic consumption in the hospital during COVID-19 pandemic, distribution of bacterial agents and antimicrobial resistance: a single-centre study. Journal of Surgery and Medicine. 2021;5:124-7.
37. Fouda HM, Sofy MR. Effect of biological synthesis of nanoparticles from Penicillium chrysogenum and traditional salt and chemical zinc nanoparticles on canola plant oil productivity and metabolic activity. Egyptian Journal of Chemistry.2022;65:1-2.
38. Gonzalez-Zorn B. Antibiotic use in the COVID-19 crisis in Spain. Clin Microbiol Infect. 2021;27(4):646-647. https://doi.org/10.1016/j.cmi.2020.09.055
39. Castro-Lopes A, Correia S, Leal C, Resende I, Soares P, Azevedo A, et al. Increase of antimicrobial consumption in a tertiary care hospital during the first phase of the COVID-19 pandemic. Antibiotics. 2021;10(7):778. https://doi.org/10.3390/antibiotics10070778
2. Aldeyab M, López-Lozano J-M, Gould IM. Global antibiotics use and resistance. In Babar Z-U-D, editor. Global Pharmaceutical Policy. Palgrave Macmillan. 2020;331-344.
3. El-Sheshtawy HS, Mahdy HM, Sofy AR, Sofy MR. Production of biosurfactant by Bacillus megaterium and its correlation with lipid peroxidation of Lactuca sativa. Egyptian Journal of Petroleum. 2022;31:1-6.
4. Piddock LJV. Reflecting on the final report of the O’Neill review on antimicrobial resistance. Lancet Infect Dis. 2016;16(7):767- 8. https://doi.org/10.1016/s1473-3099(16)30127-x
5. Razzaque M. Implement antimicrobial stewardship to reduce antimicrobial drug resistance. Expert Rev Anti Infect Ther. 2020;19:559-62.
6. Jirjees FJ, Al-Obaidi HJ, Sartaj M, Conlon-Bingham G, Farren D, Scott MG, et al. Antibiotic use and resistance in hospitals: timeseries analysis strategy for determining and prioritizing interventions. Hospital Pharmacy Europe. 2020;7:13-19.
7. Hayajneh WA, Al-Azzam S, Yusef D, Lattyak WJ, Lattyak EA, Gould I, et al. Identification of thresholds in relationships between specific antibiotic use and carbapenem-resistant Acinetobacter baumannii (CRAb) incidence rates in hospitalized patients in Jordan. J Antimicrob Chemother. 2021;76:524-30. https://doi.org/10.1093/jac/dkaa463
8. Conlon-Bingham GM, Aldeyab M, Scott M, Kearney MP, Farren D, Gilmore F, et al. Effects of antibiotic cycling policy on the incidence of healthcare-associated MRSA and Clostridioides difficile infection in secondary healthcare settings. Emerging Infect Dis. 2019;25(1):52-62. https://doi.org/10.3201/eid2501.180111
9. Organization WH (2015) Report of the 6th meeting of the WHO advisory group on integrated surveillance of antimicrobial
resistance with AGISAR 5-year strategic framework to support the implementation of the global action plan on antimicrobial
resistance (2015-2019), 10-12 June 2015, Seoul, Republic of Korea.
10. Halcomb E, McInnes S, Williams A, Ashley C, James S, Fernandez R, et al. The experiences of primary healthcare nurses during the COVID-19 pandemic in Australia. J Nurs Scholarsh. 2020;52(2):553-63. https://doi.org/10.1111/jnu.12589
11. WHO (2023) World Health Organization Model list of Essential Medicines 23rd. Geneva Switzerland.
12. Versporten A, Bolokhovets G, Ghazaryan L, Abilova V, Pyshnik G, Spasojevic T, et al. Antibiotic use in eastern Europe: a crossnational database study in coordination with the WHO Regional Office for Europe. Lancet Infectious Diseases. 2014;14(5):381- 7. https://doi.org/10.1016/s1473-3099(14)70071-4
13. MSH. Plani strategjik i rezistencës antimikrobike. Accessed online on 20.09.2023. 2019. Available from: https://msh.rks-gov.net/Documents/Index/271
14. Al-Azzam S, Mhaidat NM, Banat HA, Alfaour M, Ahmad DS, Muller A, et al. An assessment of the impact of coronavirus disease (COVID-19) pandemic on national antimicrobial consumption in Jordan. Antibiotics. 2021;10:690. https://doi.org/10.3390/
antibiotics10060690
15. Ul Mustafa Z, Salman M, Aldeyab M, Kow CS, Hasan SS. Antimicrobial consumption among hospitalized patients with COVID-19 in Pakistan. SN Compr Clin Med. 2021;3:1691-5. https://doi.org/10.1007/s42399-021-00966-5
16. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-9. https://doi.org/10.1001/jama.2020.1585
17. Lansbury L, Lim B, Baskaran V, Lim WS. Co-infections in people with COVID-19: a systematic review and meta-analysis. J Infect. 2020;81:266-75. https://doi.org/10.1016/j.jinf.2020.05.046
18. Mahmoudi H. Bacterial co-infections and antibiotic resistance in patients with COVID-19. GMS Hyg Infect Control.
2020;15:Doc35. https://doi.org/10.3205/dgkh000370
19. Bhimraj A, Morgan RL, Shumaker AH, Lavergne V, Baden L, Cheng VC-C, et al. () Infectious Diseases Society of America guidelines on the treatment and management of patients with coronavirus disease 2019 (COVID-19). Clin Infect Dis. 2020: ciaa478.
20. Hsu J. How COVID-19 is accelerating the threat of antimicrobial resistance. BMJ: 2020;369:m1983. https://doi.org/10.1136/bmj.m1983
21. Baclic DCV, Murthy S, Emeriaud G, Money D, Yeung T, Poliquin G, et al. Clinical management of patients with COVID-19 –
2nd Interim guidance. 2020. Available: https://canadiancriticalcare.org/resources/Documents/AMMI-CCCS-PHAC-clinicalguidance-Aug21-EN-FINAL.pdf Accessed: 8 November 2022.
22. Brogan DM, Mossialos E. A critical analysis of the review on antimicrobial resistance report and the infectious disease financing facility. Global health. 2016;12:1-7. https://doi.org/10.1186/s12992-016-0147-y
23. Khor WP, Olaoye O, D’Arcy N, Krockow EM, Elshenawy RA, Rutter V, et al. The need for ongoing antimicrobial stewardship
during the COVID-19 pandemic and actionable recommendations. Antibiotics. 2020;9(12):904. https://doi.org/10.3390/antibiotics9120904
24. Sofy MR, Mancy AG, Alnaggar AEAM, Refaey EE, Mohamed HI, Elnosary ME, et al. A polishing the harmful effects of broad bean mottle virus infecting broad bean plants by enhancing the immunity using different potassium concentrations. Notulae Botanicae Horti Agrobotanici Cluj-Napoca. 2022;50:12654.
25. Alanio A, Dellière S, Fodil S, Bretagne S, Mégarbane B. Prevalence of putative invasive pulmonary aspergillosis in critically ill patients with COVID-19. Lancet Respir Med. 2020;8:e48-e49. https://doi.org/10.1016/s2213-2600(20)30237-x
26. Arshad S, Kilgore P, Chaudhry ZS, Jacobsen G, Wang DD, Huitsing K, et al. Treatment with hydroxychloroquine, azithromycin, and combination in patients hospitalized with COVID-19. International Journal of Infectious Diseases. 2020;97:396-403. https://doi.org/10.1016/j.ijid.2020.06.099
27. King LM, Lovegrove MC, Shehab N, Tsay S, Budnitz DS, Geller AI, et al. Trends in US outpatient antibiotic prescriptions during the coronavirus disease 2019 pandemic. Clin Infect Dis. 2021;73(3):e652-e660. https://doi.org/10.1093/cid/ciaa1896
28. De Lusignan S, Joy M, Sherlock J, Tripathy M, van Hecke O, Gbinigie O, et al. Principle trial demonstrates scope for in-pandemic primary care antibiotic stewardship improvement. medRxiv. 2021;5(5):21250902. https://doi.org/10.3399/bjgpo.2021.0087
29. Liew Y, Lee WHL, Tan L, Kwa ALH, Thien SY, Cherng BPZ, et al. Antimicrobial stewardship programme: a vital resource for hospitals during the global coronavirus disease 2019 (COVID-19) outbreak. Int J Antimicrob Agents. 2020;56:106145. https://doi.org/10.1016/j.ijantimicag.2020.106145
30. Tran DH, Sugamata R, Hirose T, Suzuki S, Noguchi Y, Sugawara A, et al. Azithromycin, a 15-membered macrolide antibiotic, inhibits influenza A(H1N1)pdm09 virus infection by interfering with virus internalization process. J Antibiot. 2019;72(10):759-768. https://doi.org/10.1038/s41429-019-0204-x
31. Gibson PG, Yang IA, Upham JW, Reynolds PN, Hodge S, James AL, et al. Effect of azithromycin on asthma exacerbations and quality of life in adults with persistent uncontrolled asthma (AMAZES): a randomized, double-blind, placebo-controlled trial. Lancet. 2017;390(10095):659-68. https://doi.org/10.1016/s0140-6736(17)31281-3
32. Hinks TSC, Cureton L, Knight R, Wang A, Cane JL, Barber VS, et al. Azithromycin versus standard care in patients with mildto-moderate COVID-19 (ATOMIC2): an open-label, randomized trial. Lancet Respir Med. 2021;9(10):1130-40. https://doi.org/10.1016/s2213-2600(21)00263-0
33. Hinks TSC, Cureton L, Knight R, Wang A, Cane JL, Barber VS, et al. Azithromycin versus standard care in patients with mildto-moderate COVID-19 (ATOMIC2): an open-label, randomized trial. Lancet Respir Med. 2021;9(10):1130-40. https://doi.org/10.1016/s2213-2600(21)00263-0
34. Badawy IH, Hmed AA, Sofy MR, Al-Mokadem AZ. Alleviation of cadmium and nickel toxicity and phyto-stimulation of tomato plant by endophytic Micrococcus luteus and Enterobacter cloacae. Plants. 2022;11(15):2018. https://doi.org/10.3390/plants11152018
35. Grau S, Echeverria-Esnal D, Gómez-Zorrilla S, Navarrete-Rouco ME, Masclans JR, Espona M, et al. Evolution of antimicrobial consumption during the first wave of COVID-19 pandemic. Antibiotics. 2021;10(2):132. https://doi.org/10.3390/antibiotics10020132
36. HamİDİ AA, Yilmaz Ş. Antibiotic consumption in the hospital during COVID-19 pandemic, distribution of bacterial agents and antimicrobial resistance: a single-centre study. Journal of Surgery and Medicine. 2021;5:124-7.
37. Fouda HM, Sofy MR. Effect of biological synthesis of nanoparticles from Penicillium chrysogenum and traditional salt and chemical zinc nanoparticles on canola plant oil productivity and metabolic activity. Egyptian Journal of Chemistry.2022;65:1-2.
38. Gonzalez-Zorn B. Antibiotic use in the COVID-19 crisis in Spain. Clin Microbiol Infect. 2021;27(4):646-647. https://doi.org/10.1016/j.cmi.2020.09.055
39. Castro-Lopes A, Correia S, Leal C, Resende I, Soares P, Azevedo A, et al. Increase of antimicrobial consumption in a tertiary care hospital during the first phase of the COVID-19 pandemic. Antibiotics. 2021;10(7):778. https://doi.org/10.3390/antibiotics10070778
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COVID-19 pandemics and antibiotics use in the University Clinical Centre of Kosova. Pharm Pract (Granada) [Internet]. 2025 Feb. 28 [cited 2025 Apr. 21];23(1):1-7. Available from: https://pharmacypractice.org/index.php/pp/article/view/3100
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How to Cite
1.
COVID-19 pandemics and antibiotics use in the University Clinical Centre of Kosova. Pharm Pract (Granada) [Internet]. 2025 Feb. 28 [cited 2025 Apr. 21];23(1):1-7. Available from: https://pharmacypractice.org/index.php/pp/article/view/3100