Evaluation of duration of antibiotic therapy across hospitals in Scotland including the impact of COVID-19 pandemic : a segmented interrupted time series analysis

Kurdi, Amanj and Platt, Niketa and Morrison, Aidan and Proud, Euan and Gronkowski, Karen and Mueller, Tanja and Seaton, R Andrew and Malcolm, William and Bennie, Marion (2023) Evaluation of duration of antibiotic therapy across hospitals in Scotland including the impact of COVID-19 pandemic : a segmented interrupted time series analysis. Expert Review of Anti-infective Therapy, 21 (4). pp. 455-475. ISSN 1744-8336 (https://doi.org/10.1080/14787210.2023.2181789)

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Abstract

Background: Little is known about the duration of antibiotic use in hospital settings. We evaluated the duration of hospital antibiotic therapy (as a quality indicator proxy) for four commonly prescribed antibiotics (amoxicillin, co-amoxiclav, doxycycline and flucloxacillin) including the assessment of COVID-19 impact. Research design/methods: A repeated, cross-sectional study using the Hospital Electronic Prescribing and Medicines Administration system (January/2019-March/2022). Monthly median duration of therapy/duration categories were calculated, stratified by routes of administration, age and sex. Impact of COVID-19 was assessed using segmented time-series analysis. Results: There were significant variations in the median duration of therapy across routes of administration (P 7 days compared to oral or IV. Duration of therapy overall differed significantly by age. Some small statistically significant changes in the level/trends of duration of therapy were observed in the post- COVID-19 period. Conclusions: No evidence for prolonged duration of therapy were observed, even during COVID-19 pandemic. Duration of IV therapy was relatively short suggesting timely clinical review and consideration of IV to oral switch. Longer duration of therapy was observed among older patients.

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