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Antimicrobial prescribing behaviors in Covid 19 patients: A multicenter survey at Tertiary Care Hospitals of Chittagong division in Bangladesh

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Author Affiliations

  • 1Department of Pharmacology, BGC Trust Medical College, Chattogram, Bangladesh
  • 2Department of Pharmacology & Therapeutics, Chattogram International Medical College & Hospital, Chattogram, Bangladesh
  • 3Department of Pharmacology & Therapeutics, Army Medical College Bogura, Bogura, Bangladesh
  • 4National Technical Advisor-clinical services, MBBS, ECTAD-FAO, Bangladesh
  • 5Department of Endocrine and Metabolism, Chattogram Maa-O-Shishu Hospital Medical College, Chattogram, Bangladesh
  • 6Department of Medicine, Chattogram Maa-O-Shishu Hospital Medical College, Chattogram, Bangladesh
  • 7School of Information Management, Nanjing University, Jiangsu province, China
  • 8CMH Bogura, Chattogram, Bangladesh
  • 9Department of Pediatrics, BGC Trust Medical College, Chattogram, Bangladesh

Res.J.chem.sci., Volume 13, Issue (1), Pages 29-34, February,18 (2023)

Abstract

Inappropriate use of antimicrobials in the treatment of Covid-19 can result in patient harm and worldwide antimicrobial resistance. The study's objective was to explore the physician choices of empirical antimicrobial treatment in Covid-19Patients. A multicenter web-based survey was performed to explore the trend of empirical antimicrobial prescribing reported by physicians involved in Covid-19 care from June to December 2021. A questionnaire linked to a Google form was distributed via several online platforms to physicians working in the Covid specialist unit of tertiary care hospitals in Chittagong, Bangladesh. The questionnaire was distributed to 120 physicians, and 74 (89%) responded to the survey. According to 69% (n=51) of participants, there was no local antimicrobial guideline in the hospital. Almost half of the physicians (87%, n=64) mentioned that the severity of the condition was the most crucial component in starting antimicrobials. The majority of participants considered empirical antimicrobial coverage for Pseudomonas aeruginosa (68%, n=51), Klebsiella pneumonia (65%, n=48), and Streptococcus pneumoniae (57%, n=49). Meropenem and ceftriaxone were the most common antimicrobials prescribed in Patients in the Covid ward, reported by 54% (n=40) and 41% (n=30) participants, respectively. ICU patients' most commonly prescribed antimicrobials were Meropenem (84%, n=62) and Piperacillin/tazobactam (42%, n=31). According to 67% (n=49) of participants, the average length of antimicrobial treatment was seven days. The survey suggests that physicians' selections of empirical antimicrobials in Covid patients were predominantly broad-spectrum. An initial lack of national Covid management guidelines and overall inadequacy of regional or hospitalized-based antimicrobial guidelines are the confounding factors behind antimicrobial overprescribing. The study findings can be utilized to design interventions for effective antimicrobial stewardship, allowing physicians to prescribe appropriately.

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