{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T21:44:40Z","timestamp":1747172680162,"version":"3.40.5"},"reference-count":32,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2024,8,7]],"date-time":"2024-08-07T00:00:00Z","timestamp":1722988800000},"content-version":"unspecified","delay-in-days":219,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ASHE"],"published-print":{"date-parts":[[2024]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:sec id=\"S2732494X24003528_as1\">\n\t    <jats:title>Objective:<\/jats:title>\n\t    <jats:p>Inpatient antibiotic use increased during the early phases of the COVID-19 pandemic. We sought to determine whether these changes persisted in persons with and without COVID-19 infection.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X24003528_as2\">\n\t    <jats:title>Design:<\/jats:title>\n\t    <jats:p>Retrospective cohort analysis.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X24003528_as3\">\n\t    <jats:title>Setting:<\/jats:title>\n\t    <jats:p>108 Veterans Affairs (VA) facilities.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X24003528_as4\">\n\t    <jats:title>Patients:<\/jats:title>\n\t    <jats:p>Persons receiving acute inpatient care from January 2016 to October 2022.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X24003528_as5\">\n\t    <jats:title>Methods:<\/jats:title>\n\t    <jats:p>Data on antibacterial use, patient days present, and COVID-19 care were extracted from the VA Corporate Data Warehouse. Days of therapy (DOT) per 1000 days present (DP) were calculated and stratified by Centers for Disease Control and Prevention-defined antibiotic classes.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X24003528_as6\">\n\t    <jats:title>Results:<\/jats:title>\n\t    <jats:p>Antibiotic use increased from 534 DOT\/1000 DP in 11\/2019\u20132\/2020 to 588 DOT\/1000 DP in 3\/2020\u20134\/2020. Subsequently, antibiotic use decreased such that total DOT\/1000 DP was 2% less in 2020 as a whole than in 2019. Driven by treatment for community acquired pneumonia, antibiotic use was 30% higher in persons with COVID-19 than in uninfected persons in 3\/2020\u20134\/2020, but only 4% higher for the remainder of 2020. In 2022 system-wide antibiotic use was 9% less in persons with COVID-19; however, antibiotic use remained higher in persons with COVID-19 in 25% of facilities.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X24003528_as7\">\n\t    <jats:title>Discussion:<\/jats:title>\n\t    <jats:p>Although antibiotic use increased during the early phases of the COVID-19 pandemic, overall use subsequently decreased to below previous baseline levels and, in 2022, was less in persons with COVID-19 than in persons without COVID-19. However, further work needs to be done to address variances across facilities and to determine whether current levels of antibiotic use in persons with COVID-19 are justified.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1017\/ash.2024.352","type":"journal-article","created":{"date-parts":[[2024,8,7]],"date-time":"2024-08-07T02:52:28Z","timestamp":1722999148000},"source":"Crossref","is-referenced-by-count":0,"title":["Antimicrobial use before and during COVID-19: data from 108 Veterans Affairs medical centers"],"prefix":"10.1017","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4542-992X","authenticated-orcid":false,"given":"Matthew Bidwell","family":"Goetz","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2109-5939","authenticated-orcid":false,"given":"Tina","family":"Willson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael A.","family":"Rubin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vanessa W.","family":"Stevens","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4041-2811","authenticated-orcid":false,"given":"Christopher J.","family":"Graber","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2024,8,7]]},"reference":[{"key":"S2732494X24003528_ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2020.12.018"},{"key":"S2732494X24003528_ref9","unstructured":"9. Veterans Health Administration Office of Productivity and Staffing. Facility Complexity Levels, 2017. https:\/\/opes.vssc.med.va.gov\/FacilityComplexityLevels\/Pages\/default.aspx. Accessed May 22, 2019."},{"key":"S2732494X24003528_ref18","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cix474"},{"key":"S2732494X24003528_ref31","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2024.6"},{"key":"S2732494X24003528_ref19","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofz554"},{"key":"S2732494X24003528_ref14","unstructured":"14. World Health Organization. Clinical management of COVID-19: interim guidance 17 May 2020. WHO reference number: WHO\/2019-nCoV\/clinical\/2020.5. 2020."},{"key":"S2732494X24003528_ref7","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofaa578"},{"key":"S2732494X24003528_ref32","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.k5092"},{"key":"S2732494X24003528_ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2021.11.008"},{"key":"S2732494X24003528_ref27","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2016.26"},{"key":"S2732494X24003528_ref21","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciz941"},{"key":"S2732494X24003528_ref24","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cit212"},{"key":"S2732494X24003528_ref17","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2016.328"},{"key":"S2732494X24003528_ref15","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2022.194"},{"key":"S2732494X24003528_ref3","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01341-21"},{"key":"S2732494X24003528_ref28","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofad620"},{"key":"S2732494X24003528_ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2020.105949"},{"key":"S2732494X24003528_ref16","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)00462-7"},{"key":"S2732494X24003528_ref25","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofaa229"},{"key":"S2732494X24003528_ref23","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2023.35"},{"key":"S2732494X24003528_ref2","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofab236"},{"key":"S2732494X24003528_ref26","doi-asserted-by":"publisher","DOI":"10.12788\/jhm.2730"},{"key":"S2732494X24003528_ref12","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciad453"},{"key":"S2732494X24003528_ref13","unstructured":"13. National Institutes of Health. COVID-19 treatment guidelines. https:\/\/www.covid19treatmentguidelines.nih.gov\/ Accessed February 11, 2023."},{"key":"S2732494X24003528_ref22","doi-asserted-by":"publisher","DOI":"10.1017\/ash.2021.219"},{"key":"S2732494X24003528_ref30","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2020.69"},{"key":"S2732494X24003528_ref8","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofad503"},{"key":"S2732494X24003528_ref11","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2020.1277"},{"key":"S2732494X24003528_ref20","doi-asserted-by":"publisher","DOI":"10.1002\/jhm.2648"},{"key":"S2732494X24003528_ref29","doi-asserted-by":"publisher","DOI":"10.1007\/s11908-020-00734-x"},{"key":"S2732494X24003528_ref10","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa326"},{"key":"S2732494X24003528_ref5","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa1239"}],"container-title":["Antimicrobial Stewardship &amp; Healthcare Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S2732494X24003528","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,7]],"date-time":"2024-08-07T02:52:35Z","timestamp":1722999155000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S2732494X24003528\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024]]},"references-count":32,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024]]}},"alternative-id":["S2732494X24003528"],"URL":"https:\/\/doi.org\/10.1017\/ash.2024.352","relation":{},"ISSN":["2732-494X"],"issn-type":[{"type":"electronic","value":"2732-494X"}],"subject":[],"published":{"date-parts":[[2024]]},"article-number":"e109"}}