Eurosurveillance - Volume 30, Issue 35, 04 September 2025

The COVID-19 pandemic has challenged efforts to optimise rational antibacterial use due to uncertainties in treatment protocols.

We investigated the impact of COVID-19 on hospital antibacterial consumption in Belgium from 2017 to 2022, relative to the general and hospitalised population.

We analysed national reimbursement data using defined daily doses (DDD) and three metrics: DDD/1,000 inhabitants/day (DID), DDD/1,000 patient days (PD) and DDD/1,000 admissions. We performed linear regressions to analyse 6-year trends (2017–2022) and estimated predicted consumption from 2020 to 2022 using the compound annual growth rate from 2017 to 2019. To assess the impact of COVID-19, we compared observed and predicted relative changes in antibacterial consumption between 2019 (pre-pandemic) and 2020 (early pandemic) and between 2019 and 2022 (late pandemic).

From 2019 to 2020, hospital antibacterial consumption (anatomical therapeutic chemical (ATC) J01) decreased by 12% in DID but increased by 5% and 7% in DDD/1,000 PD and DDD/1,000 admissions, respectively. From 2017 to 2022, systemic antibacterials consumption declined significantly only when expressed in DID. Although all systemic antibacterial subclasses were used less than predicted between 2020 and 2022 when expressed in DID, hospital-based metrics showed higher consumption, except for macrolides and amphenicols. Broad-spectrum antibacterial consumption decreased from 2017 to 2022 when expressed in DID but fluctuated with hospital metrics, peaking in 2020, and exceeded forecasts.

COVID-19 altered trends in hospital antibacterial consumption, with contrasting patterns depending on the metric used, underline the importance of hospital-specific surveillance to support targeted stewardship and preparedness efforts.

Herpes zoster, also known as shingles, is a painful skin condition caused by varicella zoster virus. Information is lacking on incidence of herpes zoster in Finland.

To estimate age-specific annual incidence of herpes zoster over 9 years with data from several nationwide health registers.

In a nationwide study, we compiled a dataset encompassing the entire Finnish population by linking data from multiple population-based registers for 2015–23. The dataset includes records from nearly all healthcare providers in Finland. Case definitions were based on ICD-10 codes B02 and G53.0, and ICPC-2 code S70. The dataset was supplemented with information on the purchase of prescribed antiviral medication.

In total, 220,693 herpes zoster cases were identified during 2015–23 among adults aged ≥ 20 years. In 2023, when register coverage was best, age-specific annual incidence rates for the entire population varied from 3.8 to 12.2, increasing with age. Incidence was higher among females than males, and highest among elderly aged ≥ 85 years living at home without organised care. Cumulative incidence data from 2023 revealed that lifetime risk of developing herpes zoster by age 85 was 42%, and as high as 46% using the incidence among elderly living at home without organised care.

Herpes zoster incidence varied by sex and age group, and appeared to be under-reported in institutional and organised care settings. Currently, there is no official decision on herpes zoster vaccination in Finland, despite favourable recommendations from the national expert group and the National Advisory Committee on Vaccination.