With mask mandates, lockdowns, social distancing and sanitizer everywhere, other illnesses and infections seemed to disappear, a supposition backed up by new research from Monash University which reports that outpatient antibiotic prescribing in Australia fell by up to 38% during the pandemic.
The findings, presented at this year’s European Congress of Clinical Microbiology & Infectious Diseases in Lisbon, Portugal, (23-26 April) and published in the journal Clinical Infectious Diseases, are being hailed as an important step forward in antimicrobial stewardship.
Lead author, Dr Jack Skeggs from Monash Infectious Diseases, said that reducing the unnecessary use of antibiotics is the first and least costly step in preventing the development of antibiotic resistance and considering the data, it may actually be possible to maintain some of the decreases after the pandemic.
“Existing community antimicrobial stewardship programmes, community education related to personal hygiene and handwashing, culture shifts in mask wearing and social distancing and, possibly, reduced prescribing for viral syndromes may all play a role,” Dr Skeggs said.
Prior to 2020 and the pandemic there was a clear seasonal variation in prescribing, with a 29% difference between the winter months of June, July and August, and the summer months of December, January and February.
This seasonal variation disappeared during the pandemic and by the winter of 2020, there were 38% fewer antibiotics being prescribed each month than in the winters of 2018 and 2019 (1,432,000 prescriptions per month vs. 2,313,000), which was even lower than the pre-pandemic summer month averages (by 21%).
Summer 2021 showed a 23% reduction in prescriptions compared to the summers of 2018 and 2019 (1,374,000 prescriptions per month vs. 1,817,000).
Further analyses revealed that 84% of winter and 97% of summer decreases were driven by reductions in GP prescribing, despite GPs carrying out the same number of consultations as usual, and reductions were mainly in antibiotics used to treat community-acquired respiratory infections such as pneumonia and bronchitis.
In addition, reductions in antibiotic prescribing occurred in all states and territories despite significant differences in COVID case numbers and the duration of lockdowns.
For example, South Australia, in which there were no lockdowns during the study period, and Victoria, where stay at home orders were in place for 208 days in 2020, experienced comparable reductions in prescribing.
“The finding that significant reductions existed in states without high case numbers or lockdowns is promising and suggests that we may be able to maintain at least some of these decreases after the pandemic by encouraging these same culture shifts,” Dr Skeggs said.