{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T19:11:50Z","timestamp":1772219510494,"version":"3.50.1"},"reference-count":21,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"funder":[{"name":"U.S. Centers for Disease Control and Prevention's Cooperative Agreement","award":["GH20-2110"],"award-info":[{"award-number":["GH20-2110"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Despite low bacterial and fungal infection rates, increased antimicrobial use (AU) among hospitalized patients has been reported during the Coronavirus Disease 2019 (COVID-19) pandemic. We evaluated whether COVID-19 was a driver of AU and documented bacterial or fungal infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study in two hospitals each in Argentina, Brazil, and Chile. We included hospitalized adults with and without COVID-19 admitted during the pandemic (March 2020-February 2021) as well as a cohort admitted prior to the pandemic (March 2019-February 2020) with similar age and length of hospitalization. We performed multivariable logistic regressions to compare 1) patients with COVID-19 to those without who were admitted during the pandemic, and 2) patients without COVID-19 who were admitted during the pandemic to a similar patient population before the pandemic to characterize the association of COVID-19 or admission during the pandemic with rates of AU and infections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 1116 patients were included. During the pandemic, COVID-19 was not associated with receiving antimicrobials or receiving antimicrobials for a duration &gt;48 hours, but it was associated with reduced likelihood of culture-positive bacterial or fungal infection (aOR=0.35, 95% CI: 0.19\u20130.64, p\u2009&lt;\u20090.001). Compared to patients without COVID-19 admitted during the pandemic, patients admitted prior to the pandemic were more likely to have received antimicrobials (aOR=1.54, 95% CI: 1.15\u20132.07, p\u2009&lt;\u20090.01), but there was no association with receiving antimicrobials for duration&gt;48 hours or having a culture-positive bacterial or fungal infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>COVID-19 was not associated with an increased likelihood of AU in this cohort of hospitalized adults.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0343535","type":"journal-article","created":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T18:28:51Z","timestamp":1772216931000},"page":"e0343535","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Antimicrobial use and documented infection among hospitalized adults in South American acute care facilities during the coronavirus disease 2019 (COVID-19) pandemic"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1597-9966","authenticated-orcid":true,"given":"Lauren F.","family":"Dempsey","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2105-6869","authenticated-orcid":true,"given":"Hanako","family":"Osuka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivia L.","family":"McGovern","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose M.","family":"Munita","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Isabel","family":"Garzon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Icaro","family":"Boszczowski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Peters","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3995-9297","authenticated-orcid":true,"given":"Maria","family":"Spencer-Sandino","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5507-0063","authenticated-orcid":true,"given":"Matias C.","family":"Salomao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernanda C.","family":"Lessa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2746-7615","authenticated-orcid":true,"given":"Twisha S.","family":"Patel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2026,2,27]]},"reference":[{"issue":"3","key":"pone.0343535.ref001","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1016\/j.jiph.2022.12.022","article-title":"Impact of COVID-19 pandemic on multidrug resistant gram positive and gram negative pathogens: A systematic review","volume":"16","author":"U Abubakar","year":"2023","journal-title":"J Infect Public 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