Antibiotic Prescribing Patterns at COVID-19 Dedicated Wards in Bangladesh: Findings from a Single Center Study

Md Maruf Ahmed Molla; Mahmuda Yeasmin; Md Khairul Islam; Md Mohiuddin Sharif; Md Robed Amin; Tasnim Nafisa; Asish Kumar Ghosh; Monira Parveen; Md Masum Hossain Arif; Junaid Abdullah Jamiul Alam; Syed Jafar Raza Rizvi; K M Saif-Ur-Rahman; Arifa Akram; A K M Shamsuzzaman

doi:10.1016/j.infpip.2021.100134

Antibiotic Prescribing Patterns at COVID-19 Dedicated Wards in Bangladesh: Findings from a Single Center Study

Infect Prev Pract. 2021 Jun;3(2):100134. doi: 10.1016/j.infpip.2021.100134. Epub 2021 Feb 27.

Authors

Affiliations

¹ National Institute of Laboratory Medicine and Referral Center, Dhaka, Bangladesh.
² Dhaka Medical College and Hospital, Dhaka, Bangladesh.
³ Dhaka Dental College, Dhaka, Bangladesh.
⁴ Evercare Hospital, Dhaka, Bangladesh.
⁵ Johns Hopkins University, Center for Communication Programs, Dhaka, Bangladesh.
⁶ Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh.

Abstract

Background: As evidence is mounting regarding irrational and often unnecessary use of antibiotics during the COVID-19 pandemic a cross-sectional Point Prevalence Survey (PPS) (in accordance with WHO guideline) was conducted across COVID-19 dedicated wards in Dhaka Medical College and Hospital (DMCH).

Methodology: Antibiotic usage data were collected from 193 patients at different COVID-19 dedicated wards at DMCH on 11 June 2020. Comparisons in antibiotic usage were made between different groups using Pearson chi-square and Fisher's exact test.

Result: Findings reveal all surveyed patients (100%) were receiving at least one antibiotic with 133 patients (68.91%) receiving multiple antibiotics. Overall, patients presenting with the severe disease received more antibiotics. Third-generation cephalosporins (i.e. ceftriaxone) (53.8%), meropenem (40.9%), moxifloxacin (29.5%), and doxycycline (25.4%) were the four most prescribed antibiotics among surveyed patients. Diabetes mellitus (DM) was independently associated with multiple antibiotic prescribing. Abnormal C-reactive protein (CRP) and serum d-dimer were linked with higher odds of multiple antibiotic prescribing among study patients.

Conclusion: Prevalence of multiple antibiotic prescriptions was high among severely ill patients and those with abnormal CRP and d-dimer levels. Data regarding the quality of antibiotic prescribing were lacking.

Keywords: Antimicrobial resistance; Bangladesh; COVID-19; Point prevalence survey; SARS-CoV-2.