Antibiotic prescribing in an English secondary care setting before and during the COVID-19 pandemic

Not Applicable

Completed

• Conditions: Investigating the antibiotic use in patients with (COVID) pneumonia; Infections and Infestations

• Registration Number: ISRCTN14825813
• Lead Sponsor: niversity of Hertfordshire

Brief Summary

Interim results article in https://doi.org/10.3389/fmicb.2023.1298858 Retrospective study (added 04/12/2023) 2023 Other publications in https://doi.org/10.1186%2Fs12889-023-15072-5 Systematic review (added 04/12/2023)

Detailed Description

Not available

Study Timeline

• Results First Posted: 1900-01-01
• Study Start: 2022-05-23
• Study Completion: 2023-11-01
• Last Update Posted: 19 December 2023

Recruitment & Eligibility

• Status: Completed
• Sex: All
• Target Recruitment: 880

Inclusion Criteria

Phase 1
1. Adult patients 18 years and older.
2. Adult Pregnant women and immunocompromised patients.
3. Patients admitted at Bedfordshire Hospitals NHS Trust.
4. Patient admitted in critical care areas between 2019 and 2020.
5. Patients who were prescribed antibiotics for RTIs or pneumonia.

Phase 2
1. Healthcare professionals (doctors, nurses, and pharmacists).
2. Adults 18 years and older.
3. Registered with the relevant professional regulatory body; GMC, GPhC and NMC.
4. HCPs who worked during the COVID-19 pandemic and still working at the hospital.

Exclusion Criteria

Phase 1:
1. Patients who were not prescribed antibiotics.
2. Children and patients admitted for less than 48-72 hours.

Phase 2:
1. Doctors who worked before during the COVID-19 pandemic but not currently working at the Bedfordshire Hospitals NHS Trust.
2. Pharmacists who worked before during the COVID-19 pandemic but not currently working at the Bedfordshire Hospitals NHS Trust.
3. Nurses who worked before during the COVID-19 pandemic but not currently working at the Bedfordshire Hospitals NHS Trust.

Study & Design

• Study Type: Observational
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Current primary outcome measure as of 06/12/2023:<br>Phase 1:<br>The prevalence of antibiotic prescribing before and during the pandemic, additionally, identify the Antibiotic stewardship (AMS) measured using the proportion of inappropriately prescribed antibiotics at admission, 48 and 72 hours before and during the COVID-19 pandemic.<br><br>Phase 2:<br>Overall knowledge, attitudes and perceptions towards antibiotic prescribing during the pandemic, additionally, the impact of the COVID-19 pandemic on the AMS activities during the pandemic.<br><br><br><br>Previous primary outcome measure:<br>Phase 1:<br>Antibiotic stewardship (AMS) measured using the proportion of inappropriately prescribed antibiotics at admission, 48 and 72 hours before and during the COVID-19 pandemic. <br><br>Phase 2:<br>Antibiotic prescribing behaviour of healthcare professionals measured using the range of knowledge, attitudes, and perceptions during the COVID-19 pandemic.

Secondary Outcome Measures

Name	Time	Method
Phase 1: <br>1.1. AMS strategies, such as IV-to-Oral switch, antibiotic discontinuation, de-escalation, dose adjustment, and antibiotic review based on the local guidelines measured using the proportion of strategies implemented before and during the COVID-19 pandemic. <br>1.2. Laboratory and diagnostic methods, such as chest x-rays, procalcitonin test, CRP, WBCs, and fever, measured using the proportion of their use in patients infected with RTIs or pneumonia before and during the COVID-19 pandemic. <br><br>Phase 2:<br>Factors affecting the AMS implementation measured using the range of AMS practices during the COVID-19 pandemic.