Antibiotic use spikes at VA facilities during pandemic, rising to 2016 levels
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Data from more than 80 Veterans Affairs facilities showed a substantial increase in antibiotic use during the early months of the COVID-19 pandemic, rising to levels not seen since 2016, according to data presented at IDWeek.
“This study was prompted by anecdotal reports and smaller published series that demonstrated increased inpatient antibiotic use in facilities heavily impacted by COVID-19 care in the early phase of the epidemic,” Matthew B. Goetz, MD, chief of infectious diseases at the VA Greater Los Angeles Healthcare System and professor of clinical medicine at the David Geffen School of Medicine at University of California, Los Angeles, told Healio.
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Goetz and colleagues evaluated antibiotic use — measured as days of antibiotic therapy per 1,000 patient days — from January through May 2020 at 84 VA facilities, excluding facilities that provide little acute inpatient care. They compared it with antibiotic use in the same months during the 5 years before the pandemic.
The study demonstrated that from 2015 to 2019, total antibiotic use from January through May in the facilities decreased by a mean of 9.1 days of therapy (DOT)/1,000 days present (DP) per year. However, from 2019 to 2020, antibiotic use over these same months increased by 26.4 DOT/1,000 DP.
Additionally, in 2020, antibiotic DOT increased by 27.9 and 7.3 DOT/1,000 DP in facilities with the highest and lowest points of use in 2019. Overall use was around the same level seen in 2016.
According to the study, increases were observed in all drug classes, except for a decrease in narrow spectrum beta-lactam antibiotics.
“Substantial increases in antibiotic use have occurred during the COVID-19 pandemic that are not readily explained by the burden of COVID-19 care. While little change in antibiotic use was seen in some facilities with a high COVID-case burden, relatively large increases were seen in other facilities with low case burdens,” Goetz said.
“Further work is needed to assess the contribution [of] decreased admissions for elective or other noninfection-related care, de-emphasis on antimicrobial stewardship activities during preparations for the care of COVID-19 patients or changes in provider behavior to the increased rate of antibiotic use.”
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Goetz M, et al. Abstract 181. Presented at: IDWeek; Oct. 21-25, 2020 (virtual meeting).
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