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Irrational and injudicious use of antibiotics in Coronavirus Disease 19 (COVID-19) patients could be detrimental in a tropical country with a weak antibiotic stewardship policy like Bangladesh. This study aimed to focus on the antibiotic usage patterns in COVID-19 patients in Bangladesh. This prospective observational study was performed from July 2020 to June 2021 in five tertiary hospitals in Bangladesh. Data on demographic profile, disease severity, and antibiotic usage were collected directly from the patient's hospital documents. 3486 (94.4%) patients were treated with at least one antibiotic. 3261 (93.6%) patients received a single antibiotic and 225 (6.5%) received multiple antibiotics. The most used antibiotics were ceftriaxone (37.3%), co-amoxiclav (26.3%), azithromycin (10.6%), and meropenem (10.3%). According to the World Health Organization (W.H.O) AWaRe categorization, the majority (2260,69.6%) of antibiotics prescribed in this study belonged to the 'Watch' group. Culture and sensitivity reports were available in 111 cases from one center. Only 18.9% of the patients were found to be co-infected with multi-drug resistant bacteria (52.4% yield from sputum, 28.6% from urine, and 14.3% from blood). Strict antibiotic prescribing policy and antibiotic stewardship should be implemented immediately to limit the future threat of AMR in countries like Bangladesh.
Hannan et al. (Fri,) studied this question.