Imperial College London

Academic Institute

Paul Aylin

DISCOVERNOW15

The COVID-19 pandemic is challenging all aspects of healthcare, including the management of acute bacterial infection in patients with or without a COVID-19 infection. The impact of the pandemic on infection management in both hospital and community setting, antimicrobial stewardship, and long-term antimicrobial resistance (AMR) is unclear. Societal focus on mitigating this infectious disease has driven a heightened awareness of personal hygiene and environmental contamination, which may lead to reductions in transmission of bacterial infection. Reduced GP visits may be associated with the decrease of early unnecessary antibiotic use. On the other hand, changed working pattern (from face-to-face to video GP consultation), limited diagnostic capacity, and difficulties in differentiating between viral and bacterial infections may result in inadequate antibiotic prescribing decisions. If unchecked, the additional prescribing of antibiotics related to COVID-19 will add to the already increasing global challenge of AMR. To support the re-design of antimicrobial stewardship strategies which can adapt to the changing landscape of clinical practice in the UK, we will analyse the NWL COVID-19 data to answer the following research questions: how COVID-19 has affected antibiotic prescribing, and the subsequent incidence of resistant infections in North West London? We will analyse the antibiotic prescribing data since the beginning of the COVID-19 pandemic and compare with historical data, to examine the impact of the pandemic on antibiotic use in terms of prescribing volume, types of antibiotics, diagnosis of which treatment decisions based upon, and patient outcomes (resistant infections, mortality, etc). The analysis will be performed for both community (North West London) and hospital (ICHNT hospitals) settings and will look at patients infected with COVID-19 and those who are not. We will also assess the wider impact of the pandemic on primary care service utilisation for common infections including UTIs and URTIs, including triage, GP visits and consultations, and hospital referral.

05/06/2020