Avian Flu Diary: COCA Call Tomorrow (Nov 18th): Antibiotic Prescribing and COVID-19

#16,335

Treatment of COVID-19 has come a long way from the `throw-everything-at-it-but-the-kitchen-sink' approach we saw when it first emerged.

Numerous therapeutics have been tried, and many abandoned, as evidence of their effectiveness failed to materialize (see BMJ: Clinical Trial On Convalescent Plasma Showed Little Benefit For COVID-19 and WHO Solidarity Therapeutics Trial: Remdesivir, HCQ, Lopinar/Ritonavir & Interferon Disappoint).

Some winners have emerged, including dexamethasone, monoclonal antibodies, and some of the newer antivirals now under review (e.g. Pfizer's Paxlovid, and Merck's molnupiravir).

Another class of therapeutics - antibiotics - have been used (and sometimes misused) for COVID patients. While they can help treat bacterial coinfections, antibiotics have no direct impact on viral infections, and their unwarranted usage for COVID cases invites increased antibiotic resistance.

This was the topic of the following HHS presentation from February 2021.

THE INTERSECTION OF Antibiotic Resistance (AR),Antibiotic Use (AU), and COVID-19

for the Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria

While outpatient prescribing for antibiotics dropped significantly during the pandemic - likely due to the reduced number doctor's visits for non-COVID respiratory infections - usage in hospitals and in some long-term care facilities rose. The CDC reports:

Antibiotic use varies across healthcare settings

Antibiotics are not effective against COVID-19 because antibiotics do not treat infections caused by viruses. Antibiotics save lives but any time antibiotics are used, they can cause side effects and lead to antibiotic resistance.

In hospitals, antibiotic use increased for some specific antibiotics like azithromycin and ceftriaxone, which are often used to treat community-onset respiratory infections. This use likely reflects difficulties in distinguishing COVID-19 from community-acquired pneumonia caused by bacteria when patients first arrive for inpatient healthcare.
In outpatient settings, such as doctor’s offices, antibiotic use has dropped significantly. This is likely because outpatient healthcare use declined during the pandemic. Azithromycin prescribing was higher than expected, especially in geographic areas with high numbers of COVID-19 cases. This might be a reflection of its early promotion as a potential therapy, despite its ineffectiveness against viruses.
In nursing homes, antibiotic use spiked with changes in the pandemic, but remains lower overall compared to pre-pandemic measurements. In nursing home settings, azithromycin prescribing remained elevated through October 2020.

Tomorrow the CDC will hold a COCA Call on antibiotic prescribing and COVID-19. These presentations are often technical, and are of greatest interest to clinicians and healthcare providers, but others may find them useful as well.

As always, If you are unable to attend the live presentation, these (and past) webinars are archived and available for later viewing at this LINK.

Details on tomorrow's call follow:

What Clinicians, Pharmacists, and Public Health Partners Need to Know about Antibiotic Prescribing and COVID-19

= Free Continuing Education

Overview

The Centers for Disease Control and Prevention (CDC) has published several studies characterizing antibiotic prescribing during the COVID-19 pandemic in outpatient, nursing home, and hospital settings. Findings from these studies and others inform opportunities to improve antibiotic use and guide the development of resources to support healthcare professionals and health systems. Case studies representing common clinical scenarios will be discussed to support decisions related to antibiotic prescribing.

During this COCA Call, clinicians, pharmacists, and public health partners will learn about the impact of the COVID-19 pandemic on antibiotic prescribing and strategies for optimizing antibiotic prescribing.

Presenters

Lauri Hicks, DO
CAPT, U.S. Public Health Service
Director, Office of Antibiotic Stewardship
Division of Healthcare Quality Promotion
Centers for Disease Control and Prevention

Christopher Evans, PharmD
Healthcare Associated Infections and
Antimicrobial Resistance Program
Tennessee Department of Health

Jeffrey Gerber, MD, PhD
Associate Professor of Pediatrics and Epidemiology
University of Pennsylvania School of Medicine
Division of Infectious Diseases
Children’s Hospital of Philadelphia

Payal Patel, MD, MPH
Assistant Professor, Division of Infectious Diseases,
University of Michigan Health System
Medical Director of Antimicrobial Stewardship,
VA Ann Arbor Healthcare System

Call Materials

None at this time
Call Details

When:
Thursday, November 18, 2021,
2:00 PM – 3:00 PM ET

Webinar Link:
https://www.zoomgov.com/j/1602924315
Passcode: 875658

Dial In:
US: +1 669 254 5252
or +1 646 828 7666
or +1 669 216 1590
or +1 551 285 1373

International numbers