Saudi Cultural Missions Theses & Dissertations
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Item Restricted Impact of the COVID-19 pandemic on the utilisation and quality of antibiotic use in the primary care settings in England: a population-based, segmented interrupted time series analysis(Saudi Digital Library, 2023) Almutairi, Najla; Kurdi, AmanjBackground: Antimicrobial resistance (AMR) is a public health threaten driven by inappropriate use of antibiotics. During covid-19 there were concerns of increased AMR, but the evidence is limited. this study assessed the impact of Covid-19 on the quantity and quality of antibiotic utilization in primary care in England. Research design and methods: A population-based segmented interrupted time series analysis was conducted to monthly dispensed antibiotics prescriptions using the prescription cost analysis (PCA) of England from March 2019 to March 2023. Antibiotic quantity was measured using the number of antibiotics items dispensed (TID)/1000 inhabitants and Defined Daily Dose (DDD)/1000 inhabitants/day. during and after the first and second lockdown (March 2020, Novembre 2020) stratified to 11 groups based on British National Formulary (BNF) antibiotics classification. While the quality of antibiotics was evaluated using 3 quality indicators: WHO AWaRe classification, and 4C antibiotics, and proportion of broad-spectrum antibiotics. Results: For all antibiotics, there was a non-significant increased TID Before the first lockdown but, non-significant decrease in the level after the first and second lockdown. However, a significant increase in the trend after the second lockdown for all antibiotic classes was observed, with an average increase of .56, and .315 for (DDD). For the quality outcomes, there were no impact of covid 19 on WHO AWaRe antibiotics classes (Access antibiotics increased from 77% in March 2019 to 86% in March2023) and broad-spectrum antibiotics. The proportion of 4C antibiotics decreased significantly after the first lockdown (β3 = -.886, p=.019). Conclusion: The study concludes that, Covid-19 has not significantly impacted the utilization of antibiotics. Also, the quality of the utilization remains unaffected. This study supports further investigation into the impact of remote consultation during Covid-19 and use detailed patient and prescription information. Keywords: Antibiotics, COVID-19, Antimicrobial stewardship, primary healthcare, England9 0