Antibiotic consumption in hospitals during COVID-19 pandemic: a comparative study


  • Raghda RS Hussein Clinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt
  • Al Shaimaa Ibrahim Rabie Clinical Pharmacy Department, Faiyum Oncology Center, Faiyum, Egypt
  • Maryam Bin Shaman Pharmacy Department, Prince Mohammad Medical City, Ministry of Health, Aljouf, Saudi Arabia
  • Ahmed Hassan Shaaban Clinical Oncology Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
  • Alzhraa M Fahmy Tropical Medicine and Infectious Diseases Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
  • Mahmoud R Sofy Botany and Microbiology Department, Faculty of Science, AL-Azhar University, Cairo, Egypt
  • Elizabeth A Lattyak Scientific Computing Associates Corp, River Forest, IL, United States
  • Ahmed Abuelhana School of Pharmacy and Pharmaceutical Sciences, Faculty of Life and Health Sciences, University of Ulster, Coleraine, United Kingdom
  • Ibrahim A Naguib Department of Pharmaceutical Chemistry, College of Pharmacy, Taif University, Taif, Saudi Arabia
  • Ahmed M Ashour Department of Pharmacology and Toxicology, College of Pharmacy, Umm Al Qura University, Makkah, Saudi Arabia
  • Mamoon A Aldeyab Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, United Kingdom



COVID-19, antimicrobial, stewardship, resistance, antibiotic consumption


Introduction: Coronavirus disease 2019 (COVID-19) results in similar clinical characteristics as bacterial respiratory tract infections and can potentially lead to antibiotic overuse. This study aimed to determine the changes in hospital antimicrobial usage before and during the COVID-19 pandemic.

Methodology: We compared antimicrobial consumption data for 2019 and 2020. Inpatient antibiotic consumption was determined and expressed as a defined daily dose (DDD) per 100 occupied bed days, following the World Health Organization (WHO) methods. The WHO Access, Watch, and Reserve (AWaRe) classification was used.

Results: The total antimicrobial consumption in 2020 increased by 16.3% compared to consumption in 2019. In 2020, there was a reduction in fourth-generation cephalosporins (-30%), third-generation cephalosporins (-29%), and combinations of penicillins (-23%). In contrast, antibiotics that were consumed more during 2020 compared with 2019 included linezolid (374%), vancomycin (66.6%), and carbapenem (7%). Linezolid is the only antibiotic from the Reserve group on the hospital’s formulary. Antibiotic usage from the Access group was reduced by 17%, while antibiotic usage from the Watch group and the Reserve group was increased by 3% and 374%, respectively.

Conclusions: The findings show a significant shift in antibiotic usage from the Access group to the Watch and Reserve groups. The Watch and Reserve groups are known to be associated with increased resistance to antibiotics. Therefore, antimicrobial stewardship should be increased and maintained during the pandemic to ensure appropriate antibiotic use.




How to Cite

Hussein RR, Rabie ASI, Bin Shaman M, Shaaban AH, Fahmy AM, Sofy MR, Lattyak EA, Abuelhana A, Naguib IA, Ashour AM, Aldeyab MA (2022) Antibiotic consumption in hospitals during COVID-19 pandemic: a comparative study. J Infect Dev Ctries 16:1679–1686. doi: 10.3855/jidc.17148



Coronavirus Pandemic