Assesing of antibiotic prescribing in patients hospitalized with confirmed coronavirus disease 2019 (COVID-19)-results of a point prevalence survey

Introduction: Recent reports have drawn attention to the high antibiotic use in patients hospitalised for coronavirus disease 2019 (COVID- 19), resulting in concerns of increasing antimicrobial resistance with increase antibiotic use in this pandemic. Point prevalence survey (PPS) can be a quick tool to provide antibiotic prescribing information to aid antimicrobial stewardship (AMS) activities. Objectives: To describe the magnitude and structure of antibiotic utilization in COVID-19 patients using PPS. Methods: Adapting Global-PPS on antimicrobial use, the survey was conducted in a 490 beds COVID-19 hospital in Bucharest on 18 March 2021at 0800 h. Patients on systemic antibiotics were included and the prevalence of systemic (J01) antimicrobials used was calculated by WHO ATC classes. Results: Three hundred and ninety-three patients were screened. The mean age of patients was 58.9 years (IQR: 47-71), the prevalence of female gender was 55.8% (95%CI: 49.7%, 61.7%), and the mean duration of hospital stay was 14.4 days (IQR: 10-19). A total of 89.6% of patients were on antibiotics on the survey day. Three hundred and ninety-eight doses of antibiotics were prescribed in these patients. Overall, antimicrobials included in class ATC J01D (other betalactam antibacterials: Cephalosporins and Carbapenems) represented 76.8% from all amtimicrobial prescribed. Conclusion: Althouh the appropriatednes of prescription of antibiotics was not the goal of this study, intensive use of broader spectrum antimicrobials is concerning and suggestive that AMS interventions such as preauthorization and/or audit and feedback, interventions performed in our hospital in pre-pandemic era, could be the solution to improve the empiric prescription of antimicrobials for patients hospitalised for coronavirus disease 2019.