During the COVID-19 pandemic, an increase in hospital use of these medications was observed, raising concerns regarding their impact on antimicrobial resistance. The objective of this study was to evaluate antimicrobial consumption in Brazil during the COVID-19 pandemic period.

Retrospective study. Data on antimicrobial consumption were obtained from the National Controlled Products Management System. Consumption was calculated in annual Defined Daily Doses per 1,000,000 inhabitant-days (DDD/1,000,000 inhabitant-days), using the formula: (total weight dispensed in the year, in g × 1,000,000) ÷ (DDD of the substance, in g × Brazilian population of the year × 365). Multiple linear regression was performed to assess the association between consumption and the pandemic, including an interaction term between the month of dispensing and the pandemic period (2014–2019 considered pre-pandemic and 2020 onward as post-pandemic). Results were expressed as estimates with 95% confidence intervals and a significance level of α < 0.05.

The following antimicrobials were included: amoxicillin, amoxicillin-clavulanic acid, azithromycin, ceftriaxone, chloramphenicol, ciprofloxacin, clarithromycin, clindamycin, doxycycline, erythromycin, levofloxacin, sulfamethoxazole-trimethoprim, tetracycline, and vancomycin. The highest DDD value was observed for azithromycin in 2017 (2,305.13 per 1,000,000 inhabitant-days), followed by amoxicillin-clavulanic acid in 2019 (1,090.22) and amoxicillin in 2017 (1,079.20). In 2020, ceftriaxone (+175.1%), meropenem (+55.2%), and clindamycin (+23.6%) showed increased consumption compared with 2019, whereas erythromycin (−91.3%), clarithromycin (−73.5%), and amoxicillin (−59.9%) exhibited the greatest decreases. In 2021, ceftriaxone (+212.4%) consumption further increased, while erythromycin (−86.9%), clarithromycin (−73.0%), and amoxicillin (−61.0%) maintained a declining trend. In multiple linear regression, the model was statistically significant (p < 0.05) for amoxicillin, azithromycin, chloramphenicol, ciprofloxacin, clarithromycin, doxycycline, erythromycin, tetracycline, vancomycin, and meropenem. However, there was no statistically significant interaction between consumption and the pandemic period in any model.

An increase in the consumption of certain antimicrobials was observed during the post-pandemic period. However, the findings do not indicate a statistically significant association between the COVID-19 pandemic and national antimicrobial consumption.