Impact of the COVID-19 pandemic on the utilisation and quality of antibiotic use in the Scottish primary care setting: a population-based segmented interrupted time series analysis

Abstract

Background Inappropriate use of antibiotics is expected to increase during the COVID-19 pandemic but there is limited data on COVID-19’s long-term impact. We assessed the impact of COVID-19 on the quantity and quality of antibiotic use in Scotland. Research design and methods A segmented interrupted time series was applied to monthly dispensed antibiotics using Prescription Cost analysis data from March/2019 to March/2023. Antibiotics use was quantified using number of items dispensed/1000 inhabitants (TID) and defined daily dose/1000 inhabitants/day (DID). Quality of antibiotic use was assessed using key quality indicators including the WHO AWaRe classification proportion of broad-spectrum and 4C-antibiotics. Results Overall, for all antibiotics, there was a non-significant increase in TID and DID before the first lockdown (March/2020) (β1), but a decline in the level immediately after the first (β2) and second lockdowns (β4) (November/2020), albeit non-significant. However, a significant increase in the time trend after the second lockdown (β5) for all antibiotic classes was observed. COVID-19 had no negative impact on AWaRe utilisation, with proportion of all antibiotics from Access group increasing from 76% in March/2019 to 90% in March/2023. Proportion of 4C antibiotic reduced significantly after the second lockdown. Conclusions Neither the utilisation nor the quality of total antibiotic use appeared to have been significantly affected by COVID-19.

Rights

This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent.

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Identifiers

DOI

https://doi.org/10.1080/14787210.2024.2363485

Repository URI

https://strathprints.strath.ac.uk/89498/