Work

Azithromycin use before and during the COVID- 19 pandemic and the impact of implementing national evidence-based guidelines in Qatar

Year: 2024

Type: article

Abstract: Background Initial small, uncontrolled studies suggested a beneficial effect of azithromycin in individuals with COVID-19. However, subsequent studies have not confirmed its effectiveness. We assessed azithromycin usage before and during the pandemic in a national healthcare system in Qatar and the impact of implementation of evidence-based guidelines upon prescription rates. Methods Using electronic medical records, we retrieved all azithromycin prescriptions from 2019-2022 at the public healthcare system in Qatar which provides over 85% of healthcare in Qatar. Azithromycin prescription numbers and rates/100,000 population were calculated and compared over time. A course was defined as any azithromycin prescription for >5 days with no gap of >10 days. Courses were considered COVID-19-related if prescribed -3 to +10 days post positive SARS-CoV-2 PCR. Prescription rates before and after the pandemic, and before and after evidence-based guidelines implementation (in June 2020) were compared. Results During the study period, 203,806 azithromycin courses were prescribed to 166,062 individuals. Overall number of courses increased in the first 2 quarters of 2020 (average 12,857/quarter in 2019 to average of 19,297 in Q1-Q2 of 2020) and then dropped to 9,881/quarter over the next 6 quarters. COVID-19 related azithromycin courses peaked in 2020-Q2 (13,691) and dropped to 2,836 for 2020-Q3, 1,410 for 2020-Q4; 5,465 for 2021-Q1, and 4,288 for 2021-Q2. Stringent COVID-19 guidelines in June 2020 rapidly reduced azithromycin usage. Conclusions Azithromycin prescriptions increased immediately after the COVID-19 pandemic, but rapidly declined immediately after implementing evidence-based guidelines.

Source: Clinical Epidemiology and Global Health

DOI: 10.1016/j.cegh.2024.101843