We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Coronavirus Disease 2019 Vaccination Is Associated With Reduced Outpatient Antibiotic Prescribing in Older Adults With Confirmed Severe Acute Respiratory Syndrome Coronavirus 2: A Population-Wide Cohort Study.
- Authors
MacFadden, Derek R; Maxwell, Colleen; Bowdish, Dawn; Bronskill, Susan; Brooks, James; Brown, Kevin; Burrows, Lori L; Clarke, Anna; Langford, Bradley; Leung, Elizabeth; Leung, Valerie; Manuel, Doug; McGeer, Allison; Mishra, Sharmistha; Morris, Andrew M; Nott, Caroline; Raybardhan, Sumit; Sapin, Mia; Schwartz, Kevin L; So, Miranda
- Abstract
Background Antibiotics are frequently prescribed unnecessarily in outpatients with coronavirus disease 2019 (COVID-19). We sought to evaluate factors associated with antibiotic prescribing in outpatients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Methods We performed a population-wide cohort study of outpatients aged ≥66 years with polymerase chain reaction–confirmed SARS-CoV-2 from 1 January 2020 to 31 December 2021 in Ontario, Canada. We determined rates of antibiotic prescribing within 1 week before (prediagnosis) and 1 week after (postdiagnosis) reporting of the positive SARS-CoV-2 result, compared to a self-controlled period (baseline). We evaluated predictors of prescribing, including a primary-series COVID-19 vaccination, in univariate and multivariable analyses. Results We identified 13 529 eligible nursing home residents and 50 885 eligible community-dwelling adults with SARS-CoV-2 infection. Of the nursing home and community residents, 3020 (22%) and 6372 (13%), respectively, received at least 1 antibiotic prescription within 1 week of a SARS-CoV-2 positive result. Antibiotic prescribing in nursing home and community residents occurred, respectively, at 15.0 and 10.5 prescriptions per 1000 person-days prediagnosis and 20.9 and 9.8 per 1000 person-days postdiagnosis, higher than the baseline rates of 4.3 and 2.5 prescriptions per 1000 person-days. COVID-19 vaccination was associated with reduced prescribing in nursing home and community residents, with adjusted postdiagnosis incidence rate ratios (95% confidence interval) of 0.7 (0.4–1) and 0.3 (0.3–0.4), respectively. Conclusions Antibiotic prescribing was high and with little or no decline following SARS-CoV-2 diagnosis but was reduced in COVID-19–vaccinated individuals, highlighting the importance of vaccination and antibiotic stewardship in older adults with COVID-19.
- Subjects
ANTIBIOTICS; ANTIMICROBIAL stewardship; STATISTICS; COVID-19; CONFIDENCE intervals; COVID-19 vaccines; MULTIVARIATE analysis; DISEASE incidence; INAPPROPRIATE prescribing (Medicine); DRUG prescribing; INDEPENDENT living; DESCRIPTIVE statistics; RESEARCH funding; PHYSICIAN practice patterns; POLYMERASE chain reaction; OUTPATIENTS; LONGITUDINAL method; OLD age
- Publication
Clinical Infectious Diseases, 2023, Vol 77, Issue 3, p362
- ISSN
1058-4838
- Publication type
Article
- DOI
10.1093/cid/ciad190