Volume 23, Issue 3 (9-2025)
Nursing and Midwifery Journal 2025, 23(3): 84-90 |
Back to browse issues page
Research code: 30671
Ethics code: IR.IAU.URMIA.REC.1401.142
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
pashaei N, Heidari S, parizad N, nouri M, mohamadpouri M, ghanipour badelbuu S, et al . Comparison of the Consumption of Expensive Antibiotics Based on Stewardship Guidelines Before, During, and After the Coronavirus Pandemic in Urmia in the Years 2019-2024. Nursing and Midwifery Journal 2025; 23 (3) :84-90
URL: http://unmf.umsu.ac.ir/article-1-5398-en.html
URL: http://unmf.umsu.ac.ir/article-1-5398-en.html
Neda Pashaei1 
, Shiva Heidari2 , Naser Parizad3 , Mohammad Nouri2 , Mahnaz Mohamadpouri1 , Sima Ghanipour badelbuu *4 
, Violeta Lopez5 , Tuba Şengül6
, Shiva Heidari2 , Naser Parizad3 , Mohammad Nouri2 , Mahnaz Mohamadpouri1 , Sima Ghanipour badelbuu *4 , Violeta Lopez5 , Tuba Şengül6
1- Clinical Research Development Unit, Shahid Motahari Educational and Medical Center,Urmia University of Medical Sciences, Urmia, Iran
2- Department of Midwifery Nursing, Urmia Branch, Islamic Azad University, Urmia, Iran
3- Nursing Department, Patient Safety Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran
4- Department of Midwifery Nursing, Urmia Branch, Islamic Azad University, Urmia, Iran ,ghanipourfrnzvsf@gmail.com
5- School of Health – Nursing, University of New England, Australia
6- School of Nursing, Koç University, Turkey
2- Department of Midwifery Nursing, Urmia Branch, Islamic Azad University, Urmia, Iran
3- Nursing Department, Patient Safety Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran
4- Department of Midwifery Nursing, Urmia Branch, Islamic Azad University, Urmia, Iran ,
5- School of Health – Nursing, University of New England, Australia
6- School of Nursing, Koç University, Turkey
Abstract: (223 Views)
Background Using antibiotics thoughtfully not only protects patients from the risks of unnecessary treatment but also helps preserve the effectiveness of these medications by slowing the spread of antimicrobial resistance. Stewardship is an organized strategy to monitor the rational use of antibiotics, reduce drug resistance, and improve clinical outcomes. It is designed based on evidence-based guidelines and can help manage antibiotic use by providing guidance on rational antibiotic prescribing, educating physicians, limiting use, managing antibiotic prescribing software, and rotating antibiotics. This study aimed to compare the consumption of costly antibiotics based on stewardship guidelines before, during, and after the coronavirus pandemic.
Methods This descriptive comparative study was conducted at Shahid Motahari Educational and Medical Center in Urmia. Data on the consumption of expensive and inexpensive antibiotics were extracted from the hospital's HIS system, in accordance with the Ministry of Health's Stewardship Guidelines and the DOT criteria, during the period 2019-2024. Then, the percentage of consumption of costly antibiotics was calculated and compared according to the Ministry of Health Stewardship Guidelines. Finally, the data were analyzed using SPSS version 20 using repeated-measures ANOVA, and Bonferroni post-hoc test.
Results The results of comparing the three time periods showed that the use of antibiotics significantly increased during the COVID-19 period with significant changes compared to the pre-pandemic period (p < 0.001, mean = 4879.56). However, antibiotic use in the post-COVID-19 period significantly decreased compared during the COVID-19 (p < 0.001, mean = - 3604.46), although it remained higher than the pre-pandemic level (p < 0.081, mean = - 1275.10).
Conclusion The findings of this study emphasize the need to optimize antibiotic use and implement an antibiotic stewardship program to reduce side effects, costs, and drug resistance
Methods This descriptive comparative study was conducted at Shahid Motahari Educational and Medical Center in Urmia. Data on the consumption of expensive and inexpensive antibiotics were extracted from the hospital's HIS system, in accordance with the Ministry of Health's Stewardship Guidelines and the DOT criteria, during the period 2019-2024. Then, the percentage of consumption of costly antibiotics was calculated and compared according to the Ministry of Health Stewardship Guidelines. Finally, the data were analyzed using SPSS version 20 using repeated-measures ANOVA, and Bonferroni post-hoc test.
Results The results of comparing the three time periods showed that the use of antibiotics significantly increased during the COVID-19 period with significant changes compared to the pre-pandemic period (p < 0.001, mean = 4879.56). However, antibiotic use in the post-COVID-19 period significantly decreased compared during the COVID-19 (p < 0.001, mean = - 3604.46), although it remained higher than the pre-pandemic level (p < 0.081, mean = - 1275.10).
Conclusion The findings of this study emphasize the need to optimize antibiotic use and implement an antibiotic stewardship program to reduce side effects, costs, and drug resistance
Type of Study: Research |
Subject:
Miscellaneous
References
1. Ebrahimi M, Sina S, Ghabimi M. Coronavirus disease 2019 (COVID-19), perinatal and neonatal outcomes: a systematic review study. Nursing And Midwifery Journal. 2021;18(10):785-94. [google scholar]
2. Rahmani N, Nabavian M, Seyed Nematollah Roshan F, Firouzbakht M. Explaining Nurses'experiences of Social Stigma Caused by the Covid-19 Pandemic: a Phenomenological Study. Nursing and Midwifery Journal. 2022;20(7):538-48. doi: 10.52547/unmf.20.7.538. [DOI:10.52547/unmf.20.7.538]
3. Khalaginia Z, Khormaee F, Yadollahi P. The relationship of employee's personality traits and coping strategies with perceived stress in Covid-19 pandemic. Nursing And Midwifery Journal. 2023;20(12):992-1000. doi: 10.52547/unmf.20.12.992. [DOI:10.52547/unmf.20.12.992]
4. Tavakooli R. Effect of important variables; economic, social and cultural on self-medication. Daneshvar Medicine. 2001;8(34):9-12. [google scholar]
5. Moghaddam Nia A. Self medication in cold among population above 15 years of age in Babol. Journal of Babol University of Medical Science. 2007;2(1):26-32. [google scholar]
6. Tamma PD, Avdic E, Li DX, Dzintars K, Cosgrove SE. Association of adverse events with antibiotic use in hospitalized patients. JAMA Intern Med. 2017;177(9):1308-15. doi: 10.1001/jamainternmed.2017.1938. [DOI:10.1001/jamainternmed.2017.1938] [PMID] [PMCID]
7. Yazdanpanah S, Safari M, Yazdanpanah B. General practitioner, Yasu University of Medical Sciences, MSc in midwifery Yasuj University of Medical Sciences, Medical laboratory Doctor, Yasuj University of Medical Sciences, Medical Student of Shiraz University of Medical Sciences. Nursing And Midwifery Journal. 2010;8(2). [google scholar]
8. Hecker MT, Aron DC, Patel NP, Lehmann MK, Donskey CJ. Unnecessary use of antimicrobials in hospitalized patients: current patterns of misuse with an emphasis on the antianaerobic spectrum of activity. JAMA Intern Med. 2003;163(8):972-8. doi: 10.1001/archinte.163.8.972. [DOI:10.1001/archinte.163.8.972] [PMID]
9. Vogtländer NP, Van Kasteren ME, Natsch S, Kullberg B-J, Hekster YA, Van Der Meer JW. Improving the process of antibiotic therapy in daily practice: interventions to optimize timing, dosage adjustment to renal function, and switch therapy. JAMA Intern Med. 2004;164(11):1206-12. doi: 10.1001/archinte.164.11.1206. [DOI:10.1001/archinte.164.11.1206] [PMID]
10. Huttner A, Harbarth S, Carlet J, Cosgrove S, Goossens H, Holmes A, et al. Antimicrobial resistance: a global view from the 2013 World Healthcare-Associated Infections Forum. Antimicrob Resist Infect Control. 2013;2(1):31. doi: 10.1186/2047-2994-2-31. [DOI:10.1186/2047-2994-2-31] [PMID] [PMCID]
11. Brown K, Valenta K, Fisman D, Simor A, Daneman N. Hospital ward antibiotic prescribing and the risks of Clostridium difficile infection. JAMA Intern Med. 2015;175(4):626-33. doi: 10.1001/jamainternmed.2014.8273. [DOI:10.1001/jamainternmed.2014.8273] [PMID]
12. Eliopoulos GM, Cosgrove SE, Carmeli Y. The impact of antimicrobial resistance on health and economic outcomes. Clin Infect Dis. 2003;36(11):1433-7. doi: 10.1086/375081. [DOI:10.1086/375081] [PMID]
13. Talbot GH, Bradley J, Edwards Jr JE, Gilbert D, Scheld M, Bartlett JG. Bad bugs need drugs: an update on the development pipeline from the Antimicrobial Availability Task Force of the Infectious Diseases Society of America. Clin Infect Dis. 2006;42(5):657-68. doi: 10.1086/499819. [DOI:10.1086/499819] [PMID]
14. Dellit TH, Owens RC, McGowan JE, Gerding DN, Weinstein RA, Burke JP, et al. Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship. Clin Infect Dis. 2007;44(2):159-77. doi: 10.1086/510393. [DOI:10.1086/510393] [PMID]
15. Di Pentima MC, Chan S, Hossain J. Benefits of a pediatric antimicrobial stewardship program at a children's hospital. Pediatrics. 2011;128(6):1062-70. doi: 10.1542/peds.2010-3589. [DOI:10.1542/peds.2010-3589] [PMID]
16. Mohammadi F, Khademi G, Afzalaghaee M, Sasan MS. Effect of Antibiotic Stewardship targeted against vancomycin and carbapenems on antibiotic use in PICU of Doctor Sheikh hospital. Medical Journal of Mashhad university of Medical Sciences. 2015;58(5):263-9. [google scholar]
17. Stocker M, Ferrao E, Banya W, Cheong J, Macrae D, Furck A. Antibiotic surveillance on a paediatric intensive care unit: easy attainable strategy at low costs and resources. BMC Pediatr. 2012;12(1):196. doi: 10.1186/1471-2431-12-196. [DOI:10.1186/1471-2431-12-196] [PMID] [PMCID]
18. McGowan Jr J, Gerding D. Does antibiotic restriction prevent resistance?. New Horiz. 1996;4(3):370-6. [google scholar]
19. Bennett JE, Dolin R, Blaser MJ. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 8th ed. Philadelphia: Elsevier Saunders; 2015. [google scholar]
20. Davey P, Brown E, Charani E, Fenelon L, Gould IM, Holmes A, et al. Interventions to improve antibiotic prescribing practices for hospital inpatients. Cochrane Libr. 2013(4). doi: 10.1002/14651858.CD003543.pub3. [DOI:10.1002/14651858.CD003543.pub3]
21. Karanika S, Paudel S, Grigoras C, Kalbasi A, Mylonakis E. Systematic review and meta-analysis of clinical and economic outcomes from the implementation of hospital-based antimicrobial stewardship programs. Antimicrob Agents Chemother. 2016;60(8):4840-52. doi: 10.1128/AAC.00825-16. [DOI:10.1128/AAC.00825-16] [PMID] [PMCID]
22. Pollack LA, van Santen KL, Weiner LM, Dudeck MA, Edwards JR, Srinivasan A. Antibiotic stewardship programs in US acute care hospitals: findings from the 2014 National Healthcare Safety Network Annual Hospital Survey. Clin Infect Dis. 2016;63(4):443-9. doi: 10.1093/cid/ciw323. [DOI:10.1093/cid/ciw323] [PMID] [PMCID]
23. Ruiz-Ramos J, Ramirez P. Antimicrobial stewardship programs in the critical care setting. Med Intensiva. 2016 Dec;40(9):586-9. [DOI:10.1016/j.medin.2016.04.010] [PMID]
24. Elligsen M, Walker SA, Pinto R, Simor A, Mubareka S, Rachlis A, et al. Audit and feedback to reduce broad-spectrum antibiotic use among intensive care unit patients a controlled interrupted time series analysis. Infect Control Hosp Epidemiol. 2012;33(4):354-61. doi: 10.1086/664757. [DOI:10.1086/664757] [PMID]
25. Rimawi RH, Mazer MA, Siraj DS, Gooch M, Cook PP. Impact of regular collaboration between infectious diseases and critical care practitioners on antimicrobial utilization and patient outcome. Critical care medicine. 2013;41(9):2099-107. doi: 10.1097/CCM.0b013e31828e9863. [DOI:10.1097/CCM.0b013e31828e9863] [PMID]
26. Fukushige M, Ngo N-H, Lukmanto D, Fukuda S, Ohneda O. Effect of the COVID-19 pandemic on antibiotic consumption: a systematic review comparing 2019 and 2020 data. Frontiers in Public Health. 2022;10:946077. doi: 10.3389/fpubh.2022.946077. [DOI:10.3389/fpubh.2022.946077] [PMID] [PMCID]
27. Heydargoy MH. The effect of the prevalence of COVID-19 on arbitrary use of antibiotics. Iran J Microbiol. 2020;14(4):374-8. doi: 10.30699/ijmm.14.4.374. [DOI:10.30699/ijmm.14.4.374]
28. Langford BJ, So M, Raybardhan S, Leung V, Westwood D, MacFadden DR, et al. Bacterial co-infection and secondary infection in patients with COVID-19: a living rapid review and meta-analysis. Clin Microbiol Infect. 2020;26(12):1622-9. doi: 10.1016/j.cmi.2020.07.016. [DOI:10.1016/j.cmi.2020.07.016] [PMID] [PMCID]
29. Zaki SS, Sawaf GE, Ahmed AA, Baess AI, Beshey BN, ELSheredy A. Pattern of antibiotic use and bacterial co-infection in hospitalized Covid-19 patients. The Egyptian Journal of Bronchology. 2023;17(1):20. doi: 10.1186/s43168-023-00195-5. [DOI:10.1186/s43168-023-00195-5] [PMCID]
30. Velavan TP, Meyer CG. The COVID‐19 epidemic. Trop Med Int Health. 2020;25(3):278. doi: 10.1111/tmi.13383. [DOI:10.1111/tmi.13383] [PMID] [PMCID]
31. Liu J, Li H, Luo M, Liu J, Wu L, Lin X, et al. Lymphopenia predicted illness severity and recovery in patients with COVID-19: A single-center, retrospective study. PloS one. 2020;15(11):e0241659. doi: 10.1371/journal.pone.0241659. [DOI:10.1371/journal.pone.0241659] [PMID] [PMCID]
32. World Health Organization. Coronavirus disease (COVID-19): weekly epidemiological update 1, 17 August 2020. Geneva: World Health Organization; 2020. [google scholar]
33. Elsafi SH, Almutairi SH, Alsulaimani MA, AlBahrani S, Al-Maqati TN, Alanazi WK, et al. The trend of antibiotic consumption after the COVID-19 pandemic: Approach to future outbreaks. Infect Drug Resist. 2024:2227-36. doi: 10.2147/IDR.S460148. [DOI:10.2147/IDR.S460148] [PMID] [PMCID]
34. Mashayekh R, Ebadi A, Nehrir B, Moayed MS. The effect of the preceptorship training program on the participation of clinical nurses in training nursing internship students: a quasi-experimental study. BMC Nurs. 2024;23(1):395. doi: 10.1186/s12912-024-02034-4. [DOI:10.1186/s12912-024-02034-4] [PMID] [PMCID]
35. Malik SS, Mundra S. Increasing consumption of antibiotics during the COVID-19 pandemic: implications for patient health and emerging anti-microbial resistance. Antibiotics (Basel). 2022;12(1):45. doi: 10.3390/antibiotics12010045. [DOI:10.3390/antibiotics12010045] [PMID] [PMCID]
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
Contact Information
Address: Urmia University of Medical Sciences, Deputy of Research and Technology,Djahad Ave.,
Urmia-5714783734, IRAN
P.O. Box: 1138,
Tel: 044 - 331937224
Fax: 044 - 32240642
E-Mail:
j.nur.mid
gmail.com, unmfumsu.ac.ir