Publication date: May 23, 2025
Background/Objectives: Improper use of systemic antibiotics remains a significant concern in hospital settings, contributing to increased antimicrobial resistance and suboptimal clinical outcomes. The COVID-19 pandemic exacerbated this issue. This study aimed to evaluate long-term trends in antibiotic utilization in low-resource settings at a tertiary care teaching hospital, focusing specifically on the changes before, during, and after the COVID-19 pandemic. Methods: This retrospective observational study analyzed antibiotic utilization data from the University Clinical Centre of the Republic of Srpska over ten years (2015-2024). Antibiotic consumption was expressed in defined daily doses (DDD) per 100 bed-days, and compared across three periods: pre-COVID-19 (2015-2019), COVID-19 (2020-2022), and post-COVID-19 (2023-2024). Additionally, antibiotic use was categorized according to the WHO AWaRe classification. Results: Antibiotic utilization peaked during the COVID-19 period, with the highest rate observed in 2021 (91. 5 DDD/100 bed-days), despite a decrease in hospital admissions. The most frequently used antibiotics were cephalosporins, penicillins, and metronidazole. A significant increase in the use of azithromycin, meropenem, piperacillin/tazobactam, vancomycin, and colistin was noted during the COVID-19 and post-COVID-19 periods (p < 0. 05), along with a notable decline in penicillin use. Watch and Reserve antibiotic use rose significantly (p < 0. 05), while Access group use fell from 67% to 49. 2%. Conclusions: These findings underscore the lasting impact of the COVID-19 pandemic on antibiotic prescribing patterns and emphasize the urgent need for strengthened antimicrobial stewardship efforts to ensure rational antibiotic use and combat antimicrobial resistance.
Open Access PDF
| Concepts | Keywords |
|---|---|
| Antibiotics | antibiotic utilization |
| Low | AWaRe classification |
| Pandemic | COVID-19 |
| tertiary care hospital |
Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | COVID-19 Pandemic |
| disease | IDO | quality |
| drug | DRUGBANK | Pentaerythritol tetranitrate |
| drug | DRUGBANK | Metronidazole |
| drug | DRUGBANK | Azithromycin |
| drug | DRUGBANK | Meropenem |
| drug | DRUGBANK | Piperacillin |
| drug | DRUGBANK | Tazobactam |
| drug | DRUGBANK | Vancomycin |
| drug | DRUGBANK | Colistin |
| drug | DRUGBANK | Coenzyme M |
| disease | MESH | adverse drug reactions |
| disease | IDO | bacteria |
| disease | MESH | infectious diseases |
| disease | MESH | complications |
| disease | MESH | infections |
| drug | DRUGBANK | L-Aspartic Acid |
| disease | MESH | bacterial infection |
| disease | MESH | uncertainty |
| disease | MESH | co infection |
| disease | MESH | pneumonia |
| disease | MESH | critically ill |
| drug | DRUGBANK | Hydroxychloroquine |
| disease | IDO | country |
| drug | DRUGBANK | Fosfomycin |
| drug | DRUGBANK | Chloramphenicol |
| drug | DRUGBANK | Linezolid |
| drug | DRUGBANK | Teicoplanin |
| drug | DRUGBANK | Cefepime |
| drug | DRUGBANK | Ceftriaxone |
| drug | DRUGBANK | Amoxicillin |
| disease | MESH | healthcare associated infections |
| drug | DRUGBANK | Timonacic |
| disease | MESH | Emergency |
| drug | DRUGBANK | Aspartame |