Fernanda Lessa, MD, MPH Chief, CDC’s International Infection Control Program Co-author of the paper

Antibiotics’ Usage Increased During COVID-19 Pandemic

MedicalResearch.com Interview with:

Fernanda Lessa, MD, MPHChief, CDC’s International Infection Control Program Co-author of the paper

Dr. Lessa

Fernanda Lessa, MD, MPH
Chief, CDC’s International Infection Control Program
Co-author of the paper

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Data from low- and middle-income countries on the impact of the COVID-19 pandemic on antibiotic use among outpatients are sparse.

This study evaluated the changes in prescribing rates of antibiotics commonly prescribed for respiratory tract infections by outpatient providers among adults in Brazil. We observed increases during the pandemic in outpatient prescriptions of azithromycin and ceftriaxone of up 360% and 90%, respectively, based on age and sex.

MedicalResearch.com: Were antibiotics similarly used during the pandemic in the US?

Response: Increases in outpatient prescriptions of azithromycin has been reported in the US especially at the beginning of the pandemic, which we also observed in Brazil. What was unexpected was the increase in ceftriaxone use, largely as intramuscular formulations, during the pandemic in Brazil. These increases were mostly in younger adults and mainly in the first and second quarter of 2021.

Although the reasons for the increase in ceftriaxone is not known, it is possible that it reflects an attempt of healthcare providers to manage more complex respiratory infections such as pneumonia or even COVID-19 patients outside of the healthcare system given how overwhelmed hospitals were during the pandemic especially in Brazil where they observed in early 2021 the emergence of a new SARS-CoV-2 (the virus that causes COVID-19) strain, a gamma strain, causing a substantial increase in COVID-19 hospitalizations and deaths.

MedicalResearch.com: What should readers take away from your report?

Response Efforts should be taken to decrease outpatient antibiotic use in Brazil. These efforts may target primary care specialties to help reduce the risk of antimicrobial resistance and optimize patient care. Given that antibiotics are not an effective treatment for viruses and should not be used to treat COVID-19, development and incorporation of antimicrobial stewardship guidance should be considered an important component in future pandemic preparedness planning.

MedicalResearch.com: What recommendations do you have for future research as a results of this study?

Response: There is a need to explore factors influencing prescribing among primary care providers to be able to develop targeted interventions. In addition, it will be important to understand the correlation of these findings with the rates of antimicrobial resistance infections during the pandemic in the communities in Brazil.

No disclosures


Solanky D, McGovern OL, Edwards JR, Mahon G, Patel TS, Lessa FC, Hicks LA, Patel PK. Prescribing of Outpatient Antibiotics Commonly Used for Respiratory Infections Among Adults Before and During the Coronavirus Disease 2019 Pandemic in Brazil. Clin Infect Dis. 2023 Jul 5;77(Suppl 1):S12-S19. doi: 10.1093/cid/ciad183. PMID: 37406052.



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Last Updated on July 10, 2023 by Marie Benz