Consumo de antimicrobianos na primeira onda da COVID-19 em um hospital de alta complexidade do estado do Amazonas
##plugins.themes.bootstrap3.article.sidebar##
Publicado
Dec 23, 2023
##plugins.themes.bootstrap3.article.main##
Resumo
Objetivo: Identificar e quantificar o consumo de antimicrobianos em um hospital público de alta complexidade na primeira onda da COVID-19. Métodos: Estudo descritivo, transversal e retrospectivo realizado em um hospital de alta complexidade. Foram avaliados dois períodos: pré-pandemia e a primeira onda da pandemia. O consumo dos antimicrobianos foi expresso em Dose Diária Definida (DDD) por 1000 pacientes/dia. Utilizou-se a classificação ATC (Anatomical Therapeutic Chemical) /DDD da Organização Mundial de Saúde. Resultados: Durante o período de pré-pandemia a taxa mensal média de admissão hospitalar foi de 283 admissões, em contrapartida, na primeira onda da COVID-19, essa média reduziu para 138 admissões. Na primeira onda da COVID-19, o antimicrobiano mais utilizado foi a ceftriaxona, seguido por piperacilina + tazobactam, cefepime, meropenem e vancomicina. Na Unidade de Terapia Intensiva (UTI) houve um acréscimo considerável no consumo de cefalosporinas de quarta e terceira geração, carbapenêmicos e penicilinas de amplo espectro. Conclusão: De acordos com os nossos achados, percebemos que ocorreu um aumento generalizados de alguns antimicrobianos, o que pode ser um fator agravante para a resistência antimicrobiana. O impacto da pandemia sobre essa temática ainda é desconhecido, gerando preocupações sobre as consequências para gerações futuras.
##plugins.themes.bootstrap3.article.details##
Como Citar
OliveiraM. B. M. de, ManaçasL. R. A., & BadinR. C. (2023). Consumo de antimicrobianos na primeira onda da COVID-19 em um hospital de alta complexidade do estado do Amazonas. Revista Eletrônica Acervo Saúde, 23(12), e14684. https://doi.org/10.25248/reas.e14684.2023
Seção
Artigos Originais
Copyright © | Todos os direitos reservados.
A revista detém os direitos autorais exclusivos de publicação deste artigo nos termos da lei 9610/98.
Reprodução parcial
É livre o uso de partes do texto, figuras e questionário do artigo, sendo obrigatória a citação dos autores e revista.
Reprodução total
É expressamente proibida, devendo ser autorizada pela revista.
Referências
1. AGÊNCIA NACIONAL DE VIGILÂNCIA SANITÁRIA (ANVISA). Gerência Geral de Tecnologia em Serviços de Saúde. Gerência de Vigilância e Monitoramento em Serviços de Saúde. Diretriz Nacional para Elaboração de Programa de Gerenciamento do Uso de Antimicrobianos em Serviços de Saúde, 2017; 75.
2. AMARSY R, et al. Surging bloodstream infections and antimicrobial resistance during the first wave of COVID–19: a study in a large multihospital institution in the Paris region. International Journal of Infectious Diseases, 2022; 114: 90-96.
3. BACCOLINI V, et al. The impact of the COVID-19 pandemic on healthcare-associated infections in intensive care unit patients: a retrospective cohort study. Antimicrobial Resistance & Infection Control, 2021; 10(1): 87.
4. BADIN RC, et al. Clinical and pharmacological factors associated with mortality in patients with COVID-19 in a high complexity hospital in Manaus: A retrospective study. Plos one, 2023; 18(2): e0280891.
5. BAGUMA S, et al. Factors associated with mortality among the COVID-19 patients treated at Gulu Regional Referral Hospital: A retrospective study. Frontiers in Public Health, 2022; 10: 841906.
6. BALKHY HH, et al. Antimicrobial consumption in five adult intensive care units: a 33-month surveillance study. Antimicrobial Resistance and Infection Control, 2018; 7(1): 1-9.
7. BOUCHER HW e COREY GR. Epidemiology of methicillin-resistant Staphylococcus aureus. Clinical infectious diseases: an official publication of the Infectious Diseases Society of America, 2008; 46(5): S344–S349.
8. BORK JT, et al. Change in hospital antibiotic use and acquisition of multidrug-resistant gram-negative organisms after the onset of coronavirus disease 2019. Infection Control & Hospital Epidemiology, 2021; 42(9): 1115-1117.
9. BRASIL. Ministério da Saúde. Boletins epidemiológicos. Disponível em: https://www.gov.br/saude/pt-br/centrais-de-conteudo/publicacoes/boletins/epidemiologicos. Acesso em 05 de Junho de 2023.
10. BUSS LF, et al. Three-quarters attack rate of SARS-CoV-2 in the Brazilian Amazon during a largely unmitigated epidemic. Science, 2021; 371(6526): 288-292.
11. CÂNDIDO SS, et al. Retrato do uso de carbapenêmicos em um hospital pertencente ao sistema único de saúde. Research, Society and Development, 2022; 11(9): e16811931647.
12. CARS O, et al. The global need for effective antibiotics-moving towards concerted action. Drug resistance updates, 2011; 14(2): 68-69.
13. CASTRO A, et al. Increase of Antimicrobial Consumption in a Tertiary Care Hospital during the First Phase of the COVID-19 Pandemic. Antibiotics, 2021; 10(7): 778.
14. Centers for Disease Control and Prevention. Antibiotic resistance threats in the United States, 2013. US Department of Health and Human Services, CDC, 2013; 114.
15. CHANG CY e SCHIANO TD. Review article: drug hepatotoxicity. Aliment Pharmacol Ther., 2007; 25(10): 1135-1151.
16. CISNEROS JM, et al. Uso prudente de antibióticos y propuestas de mejora desde la medicina hospitalaria. Enfermedades infecciosas y microbiologia clinica, 2010; 28: 28-31.
17. DADGOSTAR P. Antimicrobial resistance: implications and costs. Infection and drug resistance, 2019; 3903-3910.
18. DAHER AA, et al. Clinical course of COVID-19 patients needing supplemental oxygen outside the intensive care unit. Scientific Reports, 2021; 11(1): 1-7.
19. FERRER-OLIVEIRAS R, et al. Immunological and physiopathological approach of COVID-19 in pregnancy. Archives of gynecology and obstetrics, 2021; 304(1): 39-57.
20. DOS SANTOS P, et al. Análise farmacoeconômica dos antimicrobianos na unidade de terapia intensiva em um hospital terciário. Research, Society and Development, 2020; 9(5): e104953179.
21. GOOSSENS H, et al. Outpatient antibiotic use in Europe and association with resistance: a cross-national database study. Lancet, 2005; 365(9459): 579-587.
22. GRAU S, et al. Antimicrobial consumption among 66 acute care hospitals in Catalonia: impact of the COVID-19 pandemic. Antibiotics, 2021; 10: 943.
23. HAMIDI AA e YILMAZ Ş. Antibiotic consumption in the hospital during COVID-19 pandemic and distribution of bacterial agents and antimicrobial resistance: A single-center study. Journal of Surgery and Medicine, 2021; 5(2): 124-127.
24. LANGFORD B, et al. Bacterial co-infection and secondary infection in patients with COVID-19: a living rapid review and meta-analysis. Clinical microbiology and infection, 2020; 26(12): 1622-1629.
25. LANSBURY L, et al. Co-infections in people with COVID-19: A systematic review and meta-analysis, 2020; 81(2): 266-275.
26. LEEKHA S, et al. General principles of antimicrobial therapy. In: Mayo clinic proceedings. Elsevier, 2011; 156-167.
27. LIEW Y, et al. Antimicrobial stewardship programme: a vital resource for hospitals during the global coronavirus disease 2019 (COVID-19) outbreak. International journal of antimicrobial agents, 2020; 56(5): 106145.
28. LODE H. Safety and tolerability of commonly prescribed oral antibiotics for the treatment of respiratory tract infections. The American journal of medicine, 2010; 123(4): S26-S38.
29. LOUREIRO RJ, et al. O uso de antibióticos e as resistências bacterianas: breves notas sobre a sua evolução. Revista Portuguesa de saúde pública, 2016; 34(1): 77-84.
30. MAJUMDER MAA, et al. Antimicrobial stewardship: Fighting antimicrobial resistance and protecting global public health. Infection and drug resistance, 2020; 4713-4738.
31. MARINHO MG, et al. Estudo de consumo de antimicrobianos do Centro de Terapia Intensiva de um hospital Universitário da Região Norte. Research, Society and Development, 2022; 11(5): e0611527592.
32. MONNET DL e HARBARTH S. Will coronavirus disease (COVID-19) have an impact on antimicrobial resistance?. Eurosurveillance, 2020; 25(45): 2001886.
33. MURRAY CJ, et al. Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. The Lancet, 2022; 399(10325): 629-655.
34. O’NEIL J. Review on Antimicrobial Resistance. Antimicrobial Resistance: Tackling a Crisis for the Health and Wealth of Nations 2014, 2014; 20.
35. RAWSON TM, et al. COVID-19 and the potential long-term impact on antimicrobial resistance. Journal of antimicrobial chemotherapy, 2020; 75(7): 1681-1684.
36. SAINI V, et al. Paradigm shift in antimicrobial resistance pattern of bacterial isolates during the COVID-19 pandemic. Antibiotics, 2021; 10(8): 954.
37. SALES I, et al. Análise comportamental da COVID-19 no brasil: Análise de dados da mobilidade, contaminação e medidas restritivas no país. Acta Scientia, 2020; 2(1): 73-85.
38. SILVA AR, et al. Increased use of antibiotics in the intensive care unit during coronavirus disease (COVID-19) pandemic in a brazilian hospital. Frontiers in pharmacology, 2021; 12: 778386.
39. UL MUSTAFA Z, et al. Antimicrobial consumption among hospitalized patients with COVID-19 in Pakistan. SN Compr Clin Med., 2021; 3(8): 1691-1695.
40. VARELA MF, et al. Bacterial resistance to antimicrobial agents. Antibiotics, 2021; 10(5): 593.
41. VELLANO PO e DE PAIVA MJM. O uso de antimicrobiano na COVID-19 e as infecções: o que sabemos. Research, Society and Development, 2020; 9(9): e841997245.
2. AMARSY R, et al. Surging bloodstream infections and antimicrobial resistance during the first wave of COVID–19: a study in a large multihospital institution in the Paris region. International Journal of Infectious Diseases, 2022; 114: 90-96.
3. BACCOLINI V, et al. The impact of the COVID-19 pandemic on healthcare-associated infections in intensive care unit patients: a retrospective cohort study. Antimicrobial Resistance & Infection Control, 2021; 10(1): 87.
4. BADIN RC, et al. Clinical and pharmacological factors associated with mortality in patients with COVID-19 in a high complexity hospital in Manaus: A retrospective study. Plos one, 2023; 18(2): e0280891.
5. BAGUMA S, et al. Factors associated with mortality among the COVID-19 patients treated at Gulu Regional Referral Hospital: A retrospective study. Frontiers in Public Health, 2022; 10: 841906.
6. BALKHY HH, et al. Antimicrobial consumption in five adult intensive care units: a 33-month surveillance study. Antimicrobial Resistance and Infection Control, 2018; 7(1): 1-9.
7. BOUCHER HW e COREY GR. Epidemiology of methicillin-resistant Staphylococcus aureus. Clinical infectious diseases: an official publication of the Infectious Diseases Society of America, 2008; 46(5): S344–S349.
8. BORK JT, et al. Change in hospital antibiotic use and acquisition of multidrug-resistant gram-negative organisms after the onset of coronavirus disease 2019. Infection Control & Hospital Epidemiology, 2021; 42(9): 1115-1117.
9. BRASIL. Ministério da Saúde. Boletins epidemiológicos. Disponível em: https://www.gov.br/saude/pt-br/centrais-de-conteudo/publicacoes/boletins/epidemiologicos. Acesso em 05 de Junho de 2023.
10. BUSS LF, et al. Three-quarters attack rate of SARS-CoV-2 in the Brazilian Amazon during a largely unmitigated epidemic. Science, 2021; 371(6526): 288-292.
11. CÂNDIDO SS, et al. Retrato do uso de carbapenêmicos em um hospital pertencente ao sistema único de saúde. Research, Society and Development, 2022; 11(9): e16811931647.
12. CARS O, et al. The global need for effective antibiotics-moving towards concerted action. Drug resistance updates, 2011; 14(2): 68-69.
13. CASTRO A, et al. Increase of Antimicrobial Consumption in a Tertiary Care Hospital during the First Phase of the COVID-19 Pandemic. Antibiotics, 2021; 10(7): 778.
14. Centers for Disease Control and Prevention. Antibiotic resistance threats in the United States, 2013. US Department of Health and Human Services, CDC, 2013; 114.
15. CHANG CY e SCHIANO TD. Review article: drug hepatotoxicity. Aliment Pharmacol Ther., 2007; 25(10): 1135-1151.
16. CISNEROS JM, et al. Uso prudente de antibióticos y propuestas de mejora desde la medicina hospitalaria. Enfermedades infecciosas y microbiologia clinica, 2010; 28: 28-31.
17. DADGOSTAR P. Antimicrobial resistance: implications and costs. Infection and drug resistance, 2019; 3903-3910.
18. DAHER AA, et al. Clinical course of COVID-19 patients needing supplemental oxygen outside the intensive care unit. Scientific Reports, 2021; 11(1): 1-7.
19. FERRER-OLIVEIRAS R, et al. Immunological and physiopathological approach of COVID-19 in pregnancy. Archives of gynecology and obstetrics, 2021; 304(1): 39-57.
20. DOS SANTOS P, et al. Análise farmacoeconômica dos antimicrobianos na unidade de terapia intensiva em um hospital terciário. Research, Society and Development, 2020; 9(5): e104953179.
21. GOOSSENS H, et al. Outpatient antibiotic use in Europe and association with resistance: a cross-national database study. Lancet, 2005; 365(9459): 579-587.
22. GRAU S, et al. Antimicrobial consumption among 66 acute care hospitals in Catalonia: impact of the COVID-19 pandemic. Antibiotics, 2021; 10: 943.
23. HAMIDI AA e YILMAZ Ş. Antibiotic consumption in the hospital during COVID-19 pandemic and distribution of bacterial agents and antimicrobial resistance: A single-center study. Journal of Surgery and Medicine, 2021; 5(2): 124-127.
24. LANGFORD B, et al. Bacterial co-infection and secondary infection in patients with COVID-19: a living rapid review and meta-analysis. Clinical microbiology and infection, 2020; 26(12): 1622-1629.
25. LANSBURY L, et al. Co-infections in people with COVID-19: A systematic review and meta-analysis, 2020; 81(2): 266-275.
26. LEEKHA S, et al. General principles of antimicrobial therapy. In: Mayo clinic proceedings. Elsevier, 2011; 156-167.
27. LIEW Y, et al. Antimicrobial stewardship programme: a vital resource for hospitals during the global coronavirus disease 2019 (COVID-19) outbreak. International journal of antimicrobial agents, 2020; 56(5): 106145.
28. LODE H. Safety and tolerability of commonly prescribed oral antibiotics for the treatment of respiratory tract infections. The American journal of medicine, 2010; 123(4): S26-S38.
29. LOUREIRO RJ, et al. O uso de antibióticos e as resistências bacterianas: breves notas sobre a sua evolução. Revista Portuguesa de saúde pública, 2016; 34(1): 77-84.
30. MAJUMDER MAA, et al. Antimicrobial stewardship: Fighting antimicrobial resistance and protecting global public health. Infection and drug resistance, 2020; 4713-4738.
31. MARINHO MG, et al. Estudo de consumo de antimicrobianos do Centro de Terapia Intensiva de um hospital Universitário da Região Norte. Research, Society and Development, 2022; 11(5): e0611527592.
32. MONNET DL e HARBARTH S. Will coronavirus disease (COVID-19) have an impact on antimicrobial resistance?. Eurosurveillance, 2020; 25(45): 2001886.
33. MURRAY CJ, et al. Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. The Lancet, 2022; 399(10325): 629-655.
34. O’NEIL J. Review on Antimicrobial Resistance. Antimicrobial Resistance: Tackling a Crisis for the Health and Wealth of Nations 2014, 2014; 20.
35. RAWSON TM, et al. COVID-19 and the potential long-term impact on antimicrobial resistance. Journal of antimicrobial chemotherapy, 2020; 75(7): 1681-1684.
36. SAINI V, et al. Paradigm shift in antimicrobial resistance pattern of bacterial isolates during the COVID-19 pandemic. Antibiotics, 2021; 10(8): 954.
37. SALES I, et al. Análise comportamental da COVID-19 no brasil: Análise de dados da mobilidade, contaminação e medidas restritivas no país. Acta Scientia, 2020; 2(1): 73-85.
38. SILVA AR, et al. Increased use of antibiotics in the intensive care unit during coronavirus disease (COVID-19) pandemic in a brazilian hospital. Frontiers in pharmacology, 2021; 12: 778386.
39. UL MUSTAFA Z, et al. Antimicrobial consumption among hospitalized patients with COVID-19 in Pakistan. SN Compr Clin Med., 2021; 3(8): 1691-1695.
40. VARELA MF, et al. Bacterial resistance to antimicrobial agents. Antibiotics, 2021; 10(5): 593.
41. VELLANO PO e DE PAIVA MJM. O uso de antimicrobiano na COVID-19 e as infecções: o que sabemos. Research, Society and Development, 2020; 9(9): e841997245.