The Spectrum of Antibiotic Prescribing During COVID-19 Pandemic: A Systematic Literature Review
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Date
2021-06-01Author
Al-Hadidi, Sara H.Alhussain, Hashim
Abdel Hadi, Hamad
Johar, Alreem
Yassine, Hadi M.
Al Thani, Asmaa A.
Eltai, Nahla O.
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Objectives: Over the last decades, there has been a significant increase in antimicrobial prescribing and
consumption associated with the development of patients’ adverse events and antimicrobial resistance (AMR)
to the point of becoming a global priority. This study aims at evaluating antibiotic prescribing during COVID-
19 pandemic from November 2019 to December 2020.
Materials and Methods: A systematic review was conducted primarily through the NCBI database, using
PRISMA guidelines to identify relevant literature for the period between November 1, 2019 and December 19,
2020, using the keywords: COVID-19 OR SARS-Cov-2 AND antibiotics restricted to the English language
excluding nonclinical articles. Five hundred twenty-seven titles were identified; all articles fulfilling the study
criteria were included, 133 through the NCBI, and 8 through Google Scholar with a combined total of 141
studies. The patient’s spectrum included all ages from neonates to elderly with all associated comorbidities,
including immune suppression.
Results: Of 28,093 patients included in the combined studies, 58.7% received antibiotics (16,490/28,093),
ranging from 1.3% to 100% coverage. Antibiotics coverage was less in children (57%) than in adults with
comorbidities (75%). Broad-spectrum antibiotics were prescribed presumptively without pathogen identifications,
which might contribute to adverse outcomes.
Conclusions: During the COVID-19 pandemic, there has been a significant and wide range of antibiotic
prescribing in patients affected by the disease, particularly in adults with underlying comorbidities, despite the
paucity of evidence of associated bacterial infections. The current practice might increase patients’ immediate
and long-term risks of adverse events, susceptibility to secondary infections as well as aggravating AMR
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