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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 3 of 3 Research Studies DisplayedRedwood R, Schulz LT, Pop-Vicas A
A perfect storm: COVID-19 and antimicrobial resistance.
The purpose of this article was to discuss key factors that contributed to the impact of the COVID-19 pandemic on antimicrobial resistance (AMR) with an emphasis on lessons learned and next steps. The authors report that the pandemic strained healthcare systems worldwide and disrupted standard infection control and antimicrobial stewardship practices, which are essential to limit the spread of multidrug-resistant organisms and decrease selective pressure related to inappropriate or unnecessary antimicrobial therapy. Disruptions to these practices are compounded by the disproportionately long hospital and intensive care unit stays observed in critically ill COVID-19 patients, leading to secondary bacterial infections that are notoriously difficult to treat and increase the use of broad-spectrum antibiotics, which can drive resistance. The article further states that the pandemic has led to shortages in personal protective equipment, increased workload, and staffing issues, all of which have disrupted routine antimicrobial stewardship activities. The article concludes that COVID-19 pandemic has highlighted the need to develop new therapeutic interventions for infectious diseases that do not rely solely on antibiotics, and stresses the importance of incorporating the lessons learned from the COVID-19 pandemic into future efforts to combat AMR.
AHRQ-funded; HS028669.
Citation: Redwood R, Schulz LT, Pop-Vicas A .
A perfect storm: COVID-19 and antimicrobial resistance.
EMJ, Microbiol Infect Dis 2022 Sep; 2022. doi: 10.33590/emjmicrobiolinfectdis/22-00082..
Keywords: COVID-19, Antimicrobial Stewardship, Antibiotics, Medication
Keller SC, Caballero TM, Tamma PD
AHRQ Author: Miller MA
Assessment of changes in visits and antibiotic prescribing during the Agency for Healthcare Research and Quality Safety Program for Improving Antibiotic Use and the COVID-19 pandemic.
This cohort study evaluated the effectiveness of the AHRQ Safety Program for Improving Antibiotic Use aimed to improve antibiotic prescribing in ambulatory practices by engaging clinicians and staff to incorporate antibiotic stewardship into practice culture, communication, and decision-making. The study ran from December 2019 through November 2020. A total of 389 ambulatory care practices with over 6.5 million visits to 5483 clinicians were compared from the baseline to completion of the program. Participants included 82 primary care practices, 103 urgent care practices, 34 federally supported practices, 21 pediatric-only practices, 39 pediatric urgent care practices, 21 pediatric-only practices, and 14 other practice types. Of the 389 practices who completed the program, 75% submitted completed data. Visits per practice per month decreased from a mean of 1624 at baseline to a nadir of 906 early in the COVID-19 pandemic (April 2020) and were 1797 at the end of the program. Total antibiotic prescribing decreased from 18.2% of visits at baseline to 9.5% at completion of the program. Acute respiratory infection (ARI) visits per practice per month decreased from a baseline of 321 to a nadir of 76 early in the pandemic (May 2020) and gradually increased through completion of the program (n = 239). Antibiotic prescribing for ARIs decreased from 39.2% at baseline to 24.7% at completion of the program.
AHRQ-authored; AHRQ-funded; 233201500020I.
Citation: Keller SC, Caballero TM, Tamma PD .
Assessment of changes in visits and antibiotic prescribing during the Agency for Healthcare Research and Quality Safety Program for Improving Antibiotic Use and the COVID-19 pandemic.
JAMA Netw Open 2022 Jul;5(7):e2220512. doi: 10.1001/jamanetworkopen.2022.20512..
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, COVID-19, Public Health, Respiratory Conditions
Vaughn VM, Gandhi T, Petty LA
Empiric antibacterial therapy and community-onset bacterial coinfection in patients hospitalized with COVID-19: a multi-hospital cohort study.
A randomly sampled cohort of 1705 patients hospitalized with COVID-19 was used. Data was collected on early empiric antibacterial therapy within 2 days of hospitalization, empiric antibacterial therapy and community-onset bacterial co-infections. Of the 1705 patients, 56.6% were prescribed early empiric antibacterial therapy, with 3.5% having a confirmed community-onset bacterial infection. Use varied across hospitals, ranging from 27% to 84%. Patients were more likely to receive the therapy if they were older, had more severe illness, had a lobar infiltrate, or were admitted to a for-profit hospital. Over the one-month period empiric antibacterial use decreased.
AHRQ-funded; HS026530; HS026725.
Citation: Vaughn VM, Gandhi T, Petty LA .
Empiric antibacterial therapy and community-onset bacterial coinfection in patients hospitalized with COVID-19: a multi-hospital cohort study.
Clin Infect Dis 2021 May 18;72(10):e533-e41. doi: 10.1093/cid/ciaa1239..
Keywords: COVID-19, Infectious Diseases, Community-Acquired Infections, Antimicrobial Stewardship, Antibiotics, Medication, Hospitalization