Changes in antibiotic stewardship during COVID 19pandemic: Experience in Internal Medicine

Background and Aim of the study: Emergence of SARS-CoV-2required enormous effort to control the spread of infection andprotect the most fragile within society This has generated an hospital focus on the threat of known and emerging infections likelyby loosening some infection control and antimicrobial management policies The current pandemic appears to result in an increased risk of antibiotic resistance Many patients receiveantibiotics to keep secondary bacterial infections under controland for the need to perform invasive procedures The stressful conditions to which staff are subjected may reduce the effectivenessof antimicrobial stewardship programs, and the massive use ofteleconsultation may have caused overprescription of antibiotics Materials and Methods: We assessed the consumption of antibiotics, and the class of antibiotics consumed, also in relation tothe documented positivity of the culture tests,in relation to thechange in the epidemiological situation on March and April 2020compared to the same period of 2019 Results: We have documented only an increased use ofmacrolides and cephalosporins but an overall reduction in the useof antibiotics in 2020 compared to the same period of 2019, evenmore evident if we consider some classes of antibiotics,in particular carbapenems Conclusions: It is unclear whether the consequences of thesechanges will have a positive or negative net impact on antimicrobial resistance rates;attention must be paid to controlling this pandemic but sustained efforts to address the long-term global threatof antimicrobial resistance should not be overlooked