Antibiotics (May 2022)

Decreased Antibiotic Consumption Coincided with Reduction in Bacteremia Caused by Bacterial Species with Respiratory Transmission Potential during the COVID-19 Pandemic

  • Vincent Chi-Chung Cheng,
  • Shuk-Ching Wong,
  • Simon Yung-Chun So,
  • Jonathan Hon-Kwan Chen,
  • Pui-Hing Chau,
  • Albert Ka-Wing Au,
  • Kelvin Hei-Yeung Chiu,
  • Xin Li,
  • Patrick Ip,
  • Vivien Wai-Man Chuang,
  • David Christopher Lung,
  • Cindy Wing-Sze Tse,
  • Rodney Allan Lee,
  • Kitty Sau-Chun Fung,
  • Wing-Kin To,
  • Raymond Wai-Man Lai,
  • Tak-Lun Que,
  • Janice Yee-Chi Lo,
  • Kwok-Yung Yuen

DOI
https://doi.org/10.3390/antibiotics11060746
Journal volume & issue
Vol. 11, no. 6
p. 746

Abstract

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Nonpharmaceutical interventions implemented during the COVID-19 pandemic (2020–2021) have provided a unique opportunity to understand their impact on the wholesale supply of antibiotics and incidences of infections represented by bacteremia due to common bacterial species in Hong Kong. The wholesale antibiotic supply data (surrogate indicator of antibiotic consumption) and notifications of scarlet fever, chickenpox, and tuberculosis collected by the Centre for Health Protection, and the data of blood cultures of patients admitted to public hospitals in Hong Kong collected by the Hospital Authority for the last 10 years, were tabulated and analyzed. A reduction in the wholesale supply of antibiotics was observed. This decrease coincided with a significant reduction in the incidence of community-onset bacteremia due to Streptococcus pyogenes, Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis, which are encapsulated bacteria with respiratory transmission potential. This reduction was sustained during two pandemic years (period 2: 2020–2021), compared with eight pre-pandemic years (period 1: 2012–2019). Although the mean number of patient admissions per year (1,704,079 vs. 1,702,484, p = 0.985) and blood culture requests per 1000 patient admissions (149.0 vs. 158.3, p = 0.132) were not significantly different between periods 1 and 2, a significant reduction in community-onset bacteremia due to encapsulated bacteria was observed in terms of the mean number of episodes per year (257 vs. 58, p p p Staphylococcus aureus or Escherichia coli. Sustained implementation of non-pharmaceutical interventions against respiratory microbes may reduce the overall consumption of antibiotics, which may have a consequential impact on antimicrobial resistance. Rebound of conventional respiratory microbial infections is likely with the relaxation of these interventions.

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