Biopsychosocial analysis of antibiotic use for the prevention or management of COVID-19 infections: A scoping review

Radolf Ansbert Nortey; Irene Akwo Kretchy; Augustina Koduah; Kwame Ohene Buabeng

doi:10.1016/j.sapharm.2022.11.011

Biopsychosocial analysis of antibiotic use for the prevention or management of COVID-19 infections: A scoping review

Res Social Adm Pharm. 2023 Apr;19(4):573-581. doi: 10.1016/j.sapharm.2022.11.011. Epub 2022 Dec 2.

Authors

Radolf Ansbert Nortey¹, Irene Akwo Kretchy², Augustina Koduah³, Kwame Ohene Buabeng⁴

Affiliations

¹ Department of Pharmacy Practice, Faculty of Pharmacy and Pharmaceutical Sciences, Private Mail Bag, University Post Office, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. Electronic address: ansbertn@gmail.com.
² Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, University of Ghana, PO Box LG 43, Legon, Accra, Ghana. Electronic address: ikretchy@ug.edu.gh.
³ Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, University of Ghana, PO Box LG 43, Legon, Accra, Ghana. Electronic address: akoduah@ug.edu.gh.
⁴ Department of Pharmacy Practice, Faculty of Pharmacy and Pharmaceutical Sciences, Private Mail Bag, University Post Office, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. Electronic address: kchiefb@gmail.com.

Abstract

Background: The novelty and complexity of the COVID-19 pandemic has resulted in various coping mechanisms adopted by individuals as a means of averting the perceived fatalities of the pandemic. The use of antibiotics in the management of COVID-19 is clinically recommended under specific conditions. However, there are increasing trends of non-adherence to the recommended criteria resulting in the unwarranted use of antibiotics as an adaptative approach to the ongoing pandemic.

Objective: The objective was to identify and classify factors associated with the unwarranted use of antibiotics in the management of COVID-19 from published literature and the perspectives of key stakeholders along a Biopsychosocial model.

Methods: Literature was searched in the following databases: PubMed/MEDLINE, Scopus, Embase and Google Scholar for studies published between 31^st December 2019 and 31^st January 2022. The Arskey and O'Malley framework modified by Levac in the six-stage methodological process was adopted for this review and included: a) identification of research questions, b) identification of relevant research articles, c) selection of studies, d) data charting and synthesis, e) summary, discussion and analysis, and f) stakeholder consultations.

Results: Out of 10,252 records identified from all sources, 12 studies were selected for inclusion in this scoping review. The selected articles reflected both antibiotic use and COVID-19 whilst capturing the biological (medical) and psychosocial perspectives. Most of the studies reported the overuse or abuse of Azithromycin especially in hospital settings. Common themes across the review and stakeholder consultations included fear, anxiety, media influences and deficits in public knowledge.

Conclusion: The findings of the study highlight the complexity of antibiotic control especially in the context of a pandemic. The identified determinants of antibiotic use provide the necessary framework to simulate health emergencies and be better positioned in the future through the development of targeted and comprehensive policies on antibiotic stewardship.

Keywords: Antibiotic; Antimicrobial resistance; COVID-19; Misuse; Overuse.

Publication types

Review

MeSH terms

Anti-Bacterial Agents* / therapeutic use
Azithromycin
COVID-19* / prevention & control
Humans
Pandemics

Substances

Anti-Bacterial Agents
Azithromycin