Dynamics between national document drug treatment options and prescribing behavior in hospitals during the COVID-19 pandemic

Cause At the beginning of the corona pandemic, much was unknown about which (regular) medicines would have a clinical effect in COVID-19 patients. To support hospitals in making local policy, the Antibiotic Policy Working Group Foundation (SWAB) has developed a document with medicinal treatment options that is frequently updated with the latest scientific insights. Results This study with data from more than 1,500 patients from six Dutch hospitals has shown that at the start of the COVID-19 pandemic, all hospitals immediately started prescribing (hydroxy)chloroquine to almost all patients. Other medicines that might be effective against COVID-19 were hardly prescribed. The more unanimously the hospitals started using (hydroxy)chloroquine, the more differently they stopped using it. The moment when (hydroxy)chloroquine was no longer prescribed differed by up to 4 weeks between hospitals. None of the hospitals still used (hydroxy)chloroquine after SWAB recommended no longer using (hydroxy)chloroquine. All hospitals have indicated that the local treatment policy was designed based on their own assessment of the scientific literature in combination with information from the SWAB national advice document.