Antibiotic use in VA hospitals declined after pandemic outbreak

According to Veterans Affairs (VA) hospitals, antibiotic prescriptions dropped significantly after the first few months of the COVID-19 pandemic. The report was released on Wednesday in Infection control and hospital epidemiology.

Previous research has shown that 65 to 80 percent of COVID-19 patients worldwide had received antibiotics in the early months of the pandemic. This was due to a lack of other treatment options, concerns about additional bacterial infections, and some early reports claiming azithromycin could be beneficial for people with the virus. But when experts realized the drug was not helping, antibiotic use for COVID-19 declined.

In the current report, investigators analyzed data on antibiotic use, patient days and COVID-19 care at 108 VA facilities from January 2016 to October 2022.

The average system-wide antibiotic use rate increased from 534 days of therapy (DOT) per 1,000 patient days (DP) before the pandemic to 588 DOT/DP in March and April 2020. During these months, antibiotic use was 30% higher among COVID-19 patients than among people without the virus, the data showed.

The higher antibiotic use in these first months was due to the treatment of community-acquired pneumonia. After April 2020, antibiotic use decreased in patients with and without COVID-19, and remained only 4% higher for the rest of 2020.

In fact, overall antibiotic use was 2% lower in 2020 than in 2019—a trend that continued into 2022. In 2022, systemwide antibiotic use among people with COVID-19 was 9% lower. Yet antibiotic use among COVID-19 patients remained higher in 25% of VA facilities, the authors pointed out.

“In summary, the rapid normalization of antibiotic use in persons with COVID-19 over the course of the pandemic and the continued downward trend in antibiotic use across the VA are reassuring, particularly as many antibiotic administrators’ usual activities were absorbed by pandemic-related tasks,” the study authors wrote. “However, there continued to be significant variation in antibiotic use across facilities.”