Nursing homes saw a big jump in certain antibiotic prescriptions early in the pandemic, and more than half of hospitalized COVID-19 patients received antibiotics in the first six months, according to two new studies.
A 150% increase in azithromycin and a 43% increase in ceftriaxone prescribing may have put residents at risk of adverse events without providing clear benefits, contend researchers from the Centers for Disease Control and Prevention in the journal Clinical Infectious Diseases.
A study from Pew Charitable Trusts, meanwhile, found that from February to July 2020, more than half of 6,000 hospital admissions for COVID-19 led to one or more antibiotic prescriptions, and half of 5,000 patients studied received one antibiotic.
What’s more, only 20% of patients admitted with the virus received a diagnosis with suspected or confirmed bacterial pneumonia, and 9% received a diagnosis of a community-acquired urinary tract infection. In fact, antibiotics typically were given to these patients before a bacterial infection was confirmed, the researchers reported.
Although many of these prescriptions may have been unnecessary, they likely were driven by the newness of COVID-19, the researchers acknowledged. It was a challenge for clinicians to differentiate between COVID-19 pneumonia and bacterial pneumonia, for example, and the spike in nursing home prescriptions were for antibiotics commonly used to treat respiratory infections. Bacterial co-infections also were a driving concern early on, they noted.
Going forward, “surveillance of nursing home prescribing practices is critical to evaluate concordance with guideline-recommended therapy and improve resident safety,” the authors concluded.
