Project 466530

Antimicrobial resistance is quickly emerging as one of the most important threats to global health. As an increasing number of microorganisms continue to develop resistance to current treatments, experts fear that this growing trend may be exacerbated by another more recent crisis - the COVID-19 pandemic. Evidence suggests that many patients infected with SARS-CoV-2 are often prescribed antibiotics to treat possible bacterial co-infection. Despite frequent antibiotic use in these patients, rates of co-infection are disproportionately low, highlighting that much of this prescribing is unnecessary. Due to the evolving nature of the pandemic, however, determining the exact proportion of COVID-19 patients who are prescribed antibiotics remains difficult. The current project will aim to estimate the prevalence of antibiotic use in patients with COVID-19 by evaluating the patterns and predictors of antibiotic prescribing in these patients. Building on previous work, emphasis will be placed on how prescribing patterns have changed over time as the pandemic has progressed. A rapid review and meta-analysis will be conducted to compile studies on bacterial co-infections and antibiotic prescribing in patients with SARS-CoV-2 between January 2020 and June 2022 across all healthcare settings and age groups. Meta-regression analyses will be performed to evaluate key predictors of prescribing including time, geography, patient characteristics, COVID-19 specific therapies such as immunomodulators, and severity. The results will provide a comprehensive picture of antibiotic use during the pandemic which may be used to improve prescribing practices, thereby confronting resistance.