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Antibiotic Use At Veterans Affairs’ Hospitals Increases During COVID-19 Pandemic, Reversing A Four-Year Downward Trend



  • Researchers observed a broad increase in antibiotic use in Department of Veterans Affairs facilities during the initial surge of COVID-19 cases, abruptly reversing a steady four-year downward trend, according to a study presented at IDWeek.
  • Use of antibiotics to treat community-acquired pneumonia and highly resistant bacteria increased from January to May 2020.
  • The study revealed an increase of antibiotic use in VA facilities that were not highly affected by COVID-19, suggesting a weakening of antibiotic stewardship practices.

ARLINGTON, Va.—New research shows a widespread increase in antibiotic use across Department of Veterans Affairs medical facilities during the initial surge of COVID-19 cases, abruptly reversing steady reductions over the prior four years, according to a new study being presented at IDWeek 2020.

The practice occurred at 84 of the largest VA facilities nationwide that were battling the pandemic, as well as in those not highly affected by COVID-19, and suggests a diversion from longstanding stewardship practices during a public health crisis.

“The pandemic provided new challenges to hospital systems that weren’t prepared to manage it—from an onslaught of patients to a shortage of rapid diagnostic tests,” says Matthew B. Goetz, M.D., lead author of the study and chief of infectious diseases at VA Greater Los Angeles Healthcare System in Los Angeles, California. “The resulting increase in antibiotic use highlights an opportunity to build a more resilient system that is strengthened against future outbreaks.” 

For these 84 facilities, antibiotic use increased by 27 days of therapy per 1000 patient days, a 4% increase. The increase was most prominent for antibiotics use to treat community acquired pneumonia and highly resistant gram-negative bacteria—from January to May of 2020. 

The new analysis looked at data from those months in earlier years to compare results and found antibiotic use per 1,000 patient days in these facilities decreased at an annual rate of 1.5% from 2015 to 2019. 

Study authors will continue investigations to determine exactly how COVID-19-related concerns changed prescription behaviors and drove antibiotic use. 

In addition to Dr. Goetz, co-authors of the study are: Christopher J. Graber, M.D., MPH, Makoto M. Jones, M.D., Vanessa W. Stevens, Ph.D., Peter A. Glassman, MBBS and Michael Rubin, M.D., Ph.D.


Contacts: Gavin Stephenson, IDSA,; Donnell Evans, VA Greater Los Angeles Healthcare System,

About IDWeek

IDWeek 2020TM is the annual meeting of the Infectious Diseases Society of America (IDSA), the Society for Healthcare Epidemiology of America (SHEA), the HIV Medicine Association (HIVMA), the Pediatric Infectious Diseases Society (PIDS) and the Society of Infectious Diseases Pharmacists (SIDP). With the theme “Advancing Science, Improving Care,” IDWeek features the latest science and bench-to-bedside approaches in prevention, diagnosis, treatment, and epidemiology of infectious diseases, including HIV, across the lifespan. IDWeek 2020 takes place virtually Oct. 21-25. For more information, visit

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