低收入和中等收入国家COVID-19患者和非COVID-19患者中抗生素处方的流行情况:系统回顾和荟萃分析

IF 4.9 4区 医学 Q1 PARASITOLOGY Pathogens and Global Health Pub Date : 2023-07-01 Epub Date: 2022-12-22 DOI:10.1080/20477724.2022.2160892
Yohanes Aditya Adhi Satria, Monica Suci Utami, Alexander Prasudi
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引用次数: 4

摘要

抗菌素耐药性(AMR)对公共卫生构成重大风险。在低收入和中等收入国家,抗生素耐药性的影响要严重得多。由于缺乏来自低收入国家(LMICs)的数据,这一主题经常被忽视。此外,COVID-19大流行可能使抗菌素耐药性问题更加严重。早期的指南建议对COVID-19患者使用抗生素,即使在没有细菌合并感染的患者中也是如此。本研究旨在调查中低收入国家感染和未感染新型冠状病毒病(COVID-19)的患者中使用抗生素的比例、抗生素使用不当的比例以及多种抗生素的使用情况。我们遵循系统评价和荟萃分析的首选报告项目(PRISMA)。我们通过在线数据库检索数据,包括PubMed、Scopus和ScienceDirect。在COVID-19患者中,抗生素处方的荟萃分析估计为0.80 (95% CI: 0.72-0.88),而非COVID-19感染患者的抗生素使用为0.54 (95% CI: 0.49-0.58)。处方抗生素中有一半(0.52,95% CI: 0.32-0.72)是不适当的处方。此外,我们发现三分之一的抗生素处方包含一种以上的抗生素(0.32,95% CI: 0.21-0.43)。总之,低收入和中等收入国家普遍使用抗生素,并且在COVID-19患者中增加了抗生素的使用。在这些处方中,不适当和多次使用的情况并不少见。这项研究有一些局限性,因为它包括两个在门诊环境下的研究,并且分析中包括的一些研究是在小范围内进行的。然而,我们的研究结果表明,采取紧急行动改善处方实践是必不可少的。
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Prevalence of antibiotics prescription amongst patients with and without COVID-19 in low- and middle-income countries: a systematic review and meta-analysis.

Antimicrobial resistance (AMR) poses a substantial risk to public health. In low-income and middle-income (LMICs) nations, the impact of AMR is significantly more severe. The absence of data from low-income countries (LMICs) causes this topic to be frequently overlooked. Additionally, the COVID-19 pandemic could make the AMR issue even worse. Earlier guidelines recommended antibiotic use in patients with COVID-19, even in those without bacterial coinfection. This study aims to investigate the proportion of antibiotic prescriptions in LMICs among patients with and without coronavirus disease-2019 (COVID-19), the proportion of inappropriate antibiotics, and multi-antibiotic prescribing. We followed the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA). We retrieved data through online databases, including PubMed, Scopus, and ScienceDirect. Amongst COVID-19 patients, the meta-analytic estimate of antibiotic prescription was 0.80 (95% CI: 0.72-0.88), whereas antibiotic use among patients with non-COVID-19 infections was 0.54 (95% CI: 0.49-0.58). Half of those prescribed antibiotics (0.52, 95% CI: 0.32-0.72) are inappropriate prescriptions. In addition, we found that one-third of antibiotics prescriptions consisted of more than one antibiotic (0.32, 95% CI: 0.21-0.43). In conclusion, antibiotics are highly prescribed across LMICs, and their use is increased in patients with COVID-19. Amongst those prescriptions, inappropriate and multiple use was not uncommon. This study has several limitations, as it included two studies in an ambulatory setting, and some of the studies included in the analysis were conducted on a small scale. Nevertheless, our findings suggest that urgent action to improve prescribing practices is essential.

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来源期刊
Pathogens and Global Health
Pathogens and Global Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-PARASITOLOGY
CiteScore
6.00
自引率
0.00%
发文量
60
审稿时长
6-12 weeks
期刊介绍: Pathogens and Global Health is a journal of infectious disease and public health that focuses on the translation of molecular, immunological, genomics and epidemiological knowledge into control measures for global health threat. The journal publishes original innovative research papers, reviews articles and interviews policy makers and opinion leaders on health subjects of international relevance. It provides a forum for scientific, ethical and political discussion of new innovative solutions for controlling and eradicating infectious diseases, with particular emphasis on those diseases affecting the poorest regions of the world.
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