Antibiotics prescription pattern in COVID-19 patients presenting in DHQ Teaching Hospital Sahiwal; Is Pakistan heading towards Post-COVID Antibiotic Resistance Era?

• Published in: Journal of Rawalpindi Medical College Vol. 25; no. 1; pp. 105 - 109
• Main Authors: Waseem, Muhammad, Rafiq, Maryam, Munir, Adeela, Kamal, Zahid, Aziz, Nauman, Iqbal, Muhammad Junaid
• Format: Journal Article
• Language: English
• Published: Rawalpindi Medical University 31-08-2021
• Subjects: Antibiotics, antibiotic resistance, COVID-19, drug prescription, SARS-cov-2
• ISSN: 1683-3562; 1683-3562
• DOI: 10.37939/jrmc.v25i1.1656

Background
There is a lack of data about antibiotic prescription trends and patterns of inappropriate antibiotic stewardship in COVID-19 patient management.

Objective
To determine frequency and pattern of antibiotic prescription in COVID-19 patients presenting in DHQ teaching hospital, Sahiwal. 

Methods
This observational cross-sectional prospective study was conducted from 1st June 2020 to 31st March 2021 in patients admitted in COVID isolation facility of DHQ Teaching hospital, Sahiwal with confirmed COVID-19 infection. Patients of all ages and of both genders were included. Data was collected by a pre-designed proforma. Data included patient’s age, gender, co-morbid conditions, type and duration of antibiotic use, and details of prescribing physicians. Descriptive statistics were applied to determine frequency and percentages of variables.

Results
Out of 800 participants, 543(67.8%) were males, and the remaining 257 (32.1%) were females.
The majority 328(41%) of patients belonged to the age group 40-60 years. 639(79.8%) patients had co-morbidities. Diabetes mellitus was the most common co-morbid condition 248 (31%). Antibiotics were prescribed to all patients 800 (100%) before admission to the COVID Isolation facility. The majority of patients 348 (43.5%) had used antibiotics for 3-7 days before admission. Macrolides class was the most commonly prescribed antibiotic 417 (52.1%). General practitioners had more tendency to prescribe antibiotics 509(64%) as compared to medical specialists 212(26.5%) and pulmonologists79 (9.8%).

Conclusion
Antibiotic stewardship needs to be improved in COVID-19 patients and prescription should be evidence-based aided by laboratory tests. The development of local guidelines for judicious antibiotic prescription in COVID-19 will help in preventing antibiotic resistance.

Key Words
Antibiotics, antibiotic resistance, COVID-19, drug prescription, SARS-cov-2