Trends in Prescribing of Antibiotics and Drugs Investigated for COVID-19 Treatment in U.S. Nursing Home Residents During the COVID-19 Pandemic.
Identifieur interne : 000251 ( Main/Corpus ); précédent : 000250; suivant : 000252Trends in Prescribing of Antibiotics and Drugs Investigated for COVID-19 Treatment in U.S. Nursing Home Residents During the COVID-19 Pandemic.
Auteurs : Katryna A. Gouin ; Stephen Creasy ; Mary Beckerson ; Martha Wdowicki ; Lauri A. Hicks ; Jennifer N. Lind ; Andrew I. Geller ; Daniel S. Budnitz ; Sarah KabbaniSource :
- Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [ 1537-6591 ] ; 2021.
Abstract
BACKGROUND
Trends in prescribing for nursing home (NH) residents, which may have been influenced by the COVID-19 pandemic, have not been characterized.
METHODS
Long-term care pharmacy data from 1,944 U.S. NHs were used to evaluate trends in prescribing of antibiotics and drugs that were investigated for COVID-19 treatment, including hydroxychloroquine, famotidine, and dexamethasone. To account for seasonal variability in antibiotic prescribing and decreased NH occupancy during the pandemic, monthly prevalence of residents with a prescription dispensed per 1,000 residents serviced was calculated from January - October and compared as relative percent change from 2019 to 2020.
RESULTS
In April 2020, prescribing was significantly higher in NHs for drugs investigated for COVID-19 treatment than 2019; including hydroxychloroquine (+563%, 95% confidence interval (CI) 5.87, 7.48) and azithromycin (+150%, 95% CI 2.37, 2.63). Ceftriaxone prescribing also increased (+43%, 95% CI 1.34, 1.54). Prescribing of dexamethasone was 36% lower in April (95% CI 0.55, 0.73) and 303% higher in July (95% CI 3.66, 4.45). Although azithromycin and ceftriaxone prescribing increased, total antibiotic prescribing among residents was lower from May (-5%, 95% CI 0.94, 0.97) through October (-4%, 95% CI 0.94, 0.97) in 2020 compared to 2019.
CONCLUSIONS
During the pandemic, large numbers of residents were prescribed drugs investigated for COVID-19 treatment, and an increase in prescribing of antibiotics commonly used for respiratory infections was observed. Prescribing of these drugs may increase the risk of adverse events, without providing clear benefits. Surveillance of NH prescribing practices is critical to evaluate concordance with guideline-recommended therapy and improve resident safety.
DOI: 10.1093/cid/ciab225
PubMed: 33693607
PubMed Central: PMC7989581
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Gouin</name><affiliation><nlm:affiliation>Chenega Corporation, contractor on assignment to the National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, GA, U.S.A.</nlm:affiliation></affiliation></author><author><name sortKey="Creasy, Stephen" sort="Creasy, Stephen" uniqKey="Creasy S" first="Stephen" last="Creasy">Stephen Creasy</name><affiliation><nlm:affiliation>PharMerica, a BrightSpring Health Services company, Louisville, KY, U.S.A.</nlm:affiliation></affiliation></author><author><name sortKey="Beckerson, Mary" sort="Beckerson, Mary" uniqKey="Beckerson M" first="Mary" last="Beckerson">Mary Beckerson</name><affiliation><nlm:affiliation>PharMerica, a BrightSpring Health Services company, Louisville, KY, U.S.A.</nlm:affiliation></affiliation></author><author><name sortKey="Wdowicki, Martha" sort="Wdowicki, Martha" uniqKey="Wdowicki M" first="Martha" last="Wdowicki">Martha Wdowicki</name><affiliation><nlm:affiliation>PharMerica, a BrightSpring Health Services company, Louisville, KY, U.S.A.</nlm:affiliation></affiliation></author><author><name sortKey="Hicks, Lauri A" sort="Hicks, Lauri A" uniqKey="Hicks L" first="Lauri A" last="Hicks">Lauri A. Hicks</name><affiliation><nlm:affiliation>Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, GA, U.S.A.</nlm:affiliation></affiliation></author><author><name sortKey="Lind, Jennifer N" sort="Lind, Jennifer N" uniqKey="Lind J" first="Jennifer N" last="Lind">Jennifer N. Lind</name><affiliation><nlm:affiliation>CDC COVID-19 Response, U.S. Centers for Disease Control and Prevention, Atlanta, GA, U.S.A.</nlm:affiliation></affiliation></author><author><name sortKey="Geller, Andrew I" sort="Geller, Andrew I" uniqKey="Geller A" first="Andrew I" last="Geller">Andrew I. Geller</name><affiliation><nlm:affiliation>CDC COVID-19 Response, U.S. Centers for Disease Control and Prevention, Atlanta, GA, U.S.A.</nlm:affiliation></affiliation></author><author><name sortKey="Budnitz, Daniel S" sort="Budnitz, Daniel S" uniqKey="Budnitz D" first="Daniel S" last="Budnitz">Daniel S. Budnitz</name><affiliation><nlm:affiliation>CDC COVID-19 Response, U.S. Centers for Disease Control and Prevention, Atlanta, GA, U.S.A.</nlm:affiliation></affiliation></author><author><name sortKey="Kabbani, Sarah" sort="Kabbani, Sarah" uniqKey="Kabbani S" first="Sarah" last="Kabbani">Sarah Kabbani</name><affiliation><nlm:affiliation>Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, GA, U.S.A.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2021">2021</date><idno type="RBID">pubmed:33693607</idno><idno type="pmid">33693607</idno><idno type="doi">10.1093/cid/ciab225</idno><idno type="pmc">PMC7989581</idno><idno type="wicri:Area/Main/Corpus">000251</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000251</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Trends in Prescribing of Antibiotics and Drugs Investigated for COVID-19 Treatment in U.S. Nursing Home Residents During the COVID-19 Pandemic.</title><author><name sortKey="Gouin, Katryna A" sort="Gouin, Katryna A" uniqKey="Gouin K" first="Katryna A" last="Gouin">Katryna A. Gouin</name><affiliation><nlm:affiliation>Chenega Corporation, contractor on assignment to the National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, GA, U.S.A.</nlm:affiliation></affiliation></author><author><name sortKey="Creasy, Stephen" sort="Creasy, Stephen" uniqKey="Creasy S" first="Stephen" last="Creasy">Stephen Creasy</name><affiliation><nlm:affiliation>PharMerica, a BrightSpring Health Services company, Louisville, KY, U.S.A.</nlm:affiliation></affiliation></author><author><name sortKey="Beckerson, Mary" sort="Beckerson, Mary" uniqKey="Beckerson M" first="Mary" last="Beckerson">Mary Beckerson</name><affiliation><nlm:affiliation>PharMerica, a BrightSpring Health Services company, Louisville, KY, U.S.A.</nlm:affiliation></affiliation></author><author><name sortKey="Wdowicki, Martha" sort="Wdowicki, Martha" uniqKey="Wdowicki M" first="Martha" last="Wdowicki">Martha Wdowicki</name><affiliation><nlm:affiliation>PharMerica, a BrightSpring Health Services company, Louisville, KY, U.S.A.</nlm:affiliation></affiliation></author><author><name sortKey="Hicks, Lauri A" sort="Hicks, Lauri A" uniqKey="Hicks L" first="Lauri A" last="Hicks">Lauri A. Hicks</name><affiliation><nlm:affiliation>Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, GA, U.S.A.</nlm:affiliation></affiliation></author><author><name sortKey="Lind, Jennifer N" sort="Lind, Jennifer N" uniqKey="Lind J" first="Jennifer N" last="Lind">Jennifer N. Lind</name><affiliation><nlm:affiliation>CDC COVID-19 Response, U.S. Centers for Disease Control and Prevention, Atlanta, GA, U.S.A.</nlm:affiliation></affiliation></author><author><name sortKey="Geller, Andrew I" sort="Geller, Andrew I" uniqKey="Geller A" first="Andrew I" last="Geller">Andrew I. Geller</name><affiliation><nlm:affiliation>CDC COVID-19 Response, U.S. Centers for Disease Control and Prevention, Atlanta, GA, U.S.A.</nlm:affiliation></affiliation></author><author><name sortKey="Budnitz, Daniel S" sort="Budnitz, Daniel S" uniqKey="Budnitz D" first="Daniel S" last="Budnitz">Daniel S. Budnitz</name><affiliation><nlm:affiliation>CDC COVID-19 Response, U.S. Centers for Disease Control and Prevention, Atlanta, GA, U.S.A.</nlm:affiliation></affiliation></author><author><name sortKey="Kabbani, Sarah" sort="Kabbani, Sarah" uniqKey="Kabbani S" first="Sarah" last="Kabbani">Sarah Kabbani</name><affiliation><nlm:affiliation>Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, GA, U.S.A.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Clinical infectious diseases : an official publication of the Infectious Diseases Society of America</title><idno type="eISSN">1537-6591</idno><imprint><date when="2021" type="published">2021</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>Trends in prescribing for nursing home (NH) residents, which may have been influenced by the COVID-19 pandemic, have not been characterized.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>Long-term care pharmacy data from 1,944 U.S. NHs were used to evaluate trends in prescribing of antibiotics and drugs that were investigated for COVID-19 treatment, including hydroxychloroquine, famotidine, and dexamethasone. To account for seasonal variability in antibiotic prescribing and decreased NH occupancy during the pandemic, monthly prevalence of residents with a prescription dispensed per 1,000 residents serviced was calculated from January - October and compared as relative percent change from 2019 to 2020.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>In April 2020, prescribing was significantly higher in NHs for drugs investigated for COVID-19 treatment than 2019; including hydroxychloroquine (+563%, 95% confidence interval (CI) 5.87, 7.48) and azithromycin (+150%, 95% CI 2.37, 2.63). Ceftriaxone prescribing also increased (+43%, 95% CI 1.34, 1.54). Prescribing of dexamethasone was 36% lower in April (95% CI 0.55, 0.73) and 303% higher in July (95% CI 3.66, 4.45). Although azithromycin and ceftriaxone prescribing increased, total antibiotic prescribing among residents was lower from May (-5%, 95% CI 0.94, 0.97) through October (-4%, 95% CI 0.94, 0.97) in 2020 compared to 2019.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>During the pandemic, large numbers of residents were prescribed drugs investigated for COVID-19 treatment, and an increase in prescribing of antibiotics commonly used for respiratory infections was observed. Prescribing of these drugs may increase the risk of adverse events, without providing clear benefits. Surveillance of NH prescribing practices is critical to evaluate concordance with guideline-recommended therapy and improve resident safety.</p></div></front></TEI><pubmed><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">33693607</PMID><DateRevised><Year>2021</Year><Month>04</Month><Day>02</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1537-6591</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2021</Year><Month>Mar</Month><Day>10</Day></PubDate></JournalIssue><Title>Clinical infectious diseases : an official publication of the Infectious Diseases Society of America</Title><ISOAbbreviation>Clin Infect Dis</ISOAbbreviation></Journal><ArticleTitle>Trends in Prescribing of Antibiotics and Drugs Investigated for COVID-19 Treatment in U.S. Nursing Home Residents During the COVID-19 Pandemic.</ArticleTitle><ELocationID EIdType="pii" ValidYN="Y">ciab225</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1093/cid/ciab225</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Trends in prescribing for nursing home (NH) residents, which may have been influenced by the COVID-19 pandemic, have not been characterized.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">Long-term care pharmacy data from 1,944 U.S. NHs were used to evaluate trends in prescribing of antibiotics and drugs that were investigated for COVID-19 treatment, including hydroxychloroquine, famotidine, and dexamethasone. To account for seasonal variability in antibiotic prescribing and decreased NH occupancy during the pandemic, monthly prevalence of residents with a prescription dispensed per 1,000 residents serviced was calculated from January - October and compared as relative percent change from 2019 to 2020.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">In April 2020, prescribing was significantly higher in NHs for drugs investigated for COVID-19 treatment than 2019; including hydroxychloroquine (+563%, 95% confidence interval (CI) 5.87, 7.48) and azithromycin (+150%, 95% CI 2.37, 2.63). Ceftriaxone prescribing also increased (+43%, 95% CI 1.34, 1.54). Prescribing of dexamethasone was 36% lower in April (95% CI 0.55, 0.73) and 303% higher in July (95% CI 3.66, 4.45). Although azithromycin and ceftriaxone prescribing increased, total antibiotic prescribing among residents was lower from May (-5%, 95% CI 0.94, 0.97) through October (-4%, 95% CI 0.94, 0.97) in 2020 compared to 2019.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">During the pandemic, large numbers of residents were prescribed drugs investigated for COVID-19 treatment, and an increase in prescribing of antibiotics commonly used for respiratory infections was observed. Prescribing of these drugs may increase the risk of adverse events, without providing clear benefits. Surveillance of NH prescribing practices is critical to evaluate concordance with guideline-recommended therapy and improve resident safety.</AbstractText><CopyrightInformation>© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Gouin</LastName><ForeName>Katryna A</ForeName><Initials>KA</Initials><AffiliationInfo><Affiliation>Chenega Corporation, contractor on assignment to the National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, GA, U.S.A.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Creasy</LastName><ForeName>Stephen</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>PharMerica, a BrightSpring Health Services company, Louisville, KY, U.S.A.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Beckerson</LastName><ForeName>Mary</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>PharMerica, a BrightSpring Health Services company, Louisville, KY, U.S.A.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wdowicki</LastName><ForeName>Martha</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>PharMerica, a BrightSpring Health Services company, Louisville, KY, U.S.A.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hicks</LastName><ForeName>Lauri A</ForeName><Initials>LA</Initials><AffiliationInfo><Affiliation>Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, GA, U.S.A.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lind</LastName><ForeName>Jennifer N</ForeName><Initials>JN</Initials><AffiliationInfo><Affiliation>CDC COVID-19 Response, U.S. Centers for Disease Control and Prevention, Atlanta, GA, U.S.A.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Geller</LastName><ForeName>Andrew I</ForeName><Initials>AI</Initials><AffiliationInfo><Affiliation>CDC COVID-19 Response, U.S. Centers for Disease Control and Prevention, Atlanta, GA, U.S.A.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Budnitz</LastName><ForeName>Daniel S</ForeName><Initials>DS</Initials><AffiliationInfo><Affiliation>CDC COVID-19 Response, U.S. Centers for Disease Control and Prevention, Atlanta, GA, U.S.A.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kabbani</LastName><ForeName>Sarah</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, GA, U.S.A.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2021</Year><Month>03</Month><Day>10</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Clin Infect Dis</MedlineTA><NlmUniqueID>9203213</NlmUniqueID><ISSNLinking>1058-4838</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">COVID-19</Keyword><Keyword MajorTopicYN="N">adverse drug events</Keyword><Keyword MajorTopicYN="N">antibiotic stewardship</Keyword><Keyword MajorTopicYN="N">nursing home</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2021</Year><Month>01</Month><Day>04</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2021</Year><Month>3</Month><Day>11</Day><Hour>6</Hour><Minute>48</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2021</Year><Month>3</Month><Day>12</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2021</Year><Month>3</Month><Day>12</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>aheadofprint</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">33693607</ArticleId><ArticleId IdType="pii">6167836</ArticleId><ArticleId IdType="doi">10.1093/cid/ciab225</ArticleId><ArticleId IdType="pmc">PMC7989581</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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