TY - JOUR
AU - Ciaccio, Laura
AU - Donnan, Peter T.
AU - Parcell, Benjamin J.
AU - Marwick, Charis A.
PY - 2024
DA - April
TI - Community antibiotic prescribing in patients with COVID-19 across three pandemic waves: a population-based study in Scotland, UK
JO - BMJ Open
VL - 14
IS - 4
DO - https://doi.org/10.1136/bmjopen-2023-081930
AB - Objectives: This study aims to examine community antibiotic prescribing across a complete geographical area for people with a positive COVID-19 test across three pandemic waves, and to examine health and demographic factors associated with antibiotic prescribing. Design: A population-based study using administrative data. Setting: A complete geographical region within Scotland, UK. Participants: Residents of two National Health Service Scotland health boards with SARS-CoV-2 virus test results from 1 February 2020 to 31 March 2022 (n=184 954). Individuals with a positive test result (n=16 025) had data linked to prescription and hospital admission data ±28 days of the test, general practice data for high-risk comorbidities and demographic data. Outcome measures: The associations between patient factors and the odds of antibiotic prescription in COVID-19 episodes across three pandemic waves from multivariate binary logistic regression. Results: Data included 768 206 tests for 184 954 individuals, identifying 16 240 COVID-19 episodes involving 16 025 individuals. There were 3263 antibiotic prescriptions ±28 days for 2395 episodes. 35.6% of episodes had a prescription only before the test date, 52.3% of episodes after and 12.1% before and after. Antibiotic prescribing reduced over time: 20.4% of episodes in wave 1, 17.7% in wave 2 and 12.0% in wave 3. In multivariate logistic regression, being female (OR 1.31, 95% CI 1.19 to 1.45), older (OR 3.02, 95% CI 2.50 to 3.68 75+ vs &lt;25 years), having a high-risk comorbidity (OR 1.45, 95% CI 1.31 to 1.61), a hospital admission ±28 days of an episode (OR 1.58, 95% CI 1.42 to 1.77) and health board region (OR 1.14, 95% CI 1.03 to 1.25, board B vs A) increased the odds of receiving an antibiotic. Conclusion: Community antibiotic prescriptions in COVID-19 episodes were uncommon in this population and likelihood was associated with patient factors. The reduction over pandemic waves may represent increased knowledge regarding COVID-19 treatment and/or evolving symptomatology.
PB - BMJ Publishing Group
UR - https://discovery.dundee.ac.uk/en/publications/96058514-09b9-4452-9572-6a98feb6e809
KW - Coronavirus (COVID-19)
ER