{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:06:03Z","timestamp":1792785963928,"version":"4.5.0"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,3,26]],"date-time":"2025-03-26T00:00:00Z","timestamp":1742947200000},"content-version":"vor","delay-in-days":22,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["221579\/Z\/20\/Z"],"award-info":[{"award-number":["221579\/Z\/20\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Ineos Oxford Institute for Antimicrobial Research"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study aimed to evaluate the trends in antimicrobial prescription during the first 1.5 years of COVID-19 pandemic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was an observational, retrospective cohort study using patient-level data from Bangladesh, Brazil, India, Italy, Malawi, Nigeria, South Korea, Switzerland and Turkey from patients with pneumonia and\/or acute respiratory distress syndrome and\/or sepsis, regardless of COVID-19 positivity, who were admitted to critical care units or COVID-19 specialized wards. The changes of antimicrobial prescription between pre-pandemic and pandemic were estimated using logistic or linear regression. Pandemic effects on month-wise antimicrobial usage were evaluated using interrupted time series analyses (ITSAs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Antimicrobials for which prescriptions significantly increased during the pandemic were as follows: meropenem in Bangladesh (95% CI: 1.94\u20134.07) with increased prescribed daily dose (PDD) (95% CI: 1.17\u20131.58) and Turkey (95% CI: 1.09\u20131.58), moxifloxacin in Bangladesh (95% CI: 4.11\u201311.87) with increased days of therapy (DOT) (95% CI: 1.14\u20132.56), piperacillin\/tazobactam in Italy (95% CI: 1.07\u20131.48) with increased DOT (95% CI: 1.01\u20131.25) and PDD (95% CI: 1.05\u20131.21) and azithromycin in Bangladesh (95% CI: 3.36\u201321.77) and Brazil (95% CI: 2.33\u20138.42). ITSA showed a significant drop in azithromycin usage in India (95% CI: \u22128.38 to \u22123.49\u2005g\/100 patients) and South Korea (95% CI: \u22122.83 to \u22121.89\u2005g\/100 patients) after WHO guidelines v1 release and increased meropenem usage (95% CI: 93.40\u2013126.48\u2005g\/100 patients) and moxifloxacin (95% CI: 5.40\u201313.98\u2005g\/100 patients) in Bangladesh and sulfamethoxazole\/trimethoprim in India (95% CI: 0.92\u20139.32\u2005g\/100 patients) following the Delta variant emergence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study reinforces the importance of developing antimicrobial stewardship in the clinical settings during inter-pandemic periods.<\/jats:p>\n                  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