Inadequate use of antibiotics in the covid-19 era: effectiveness of antibiotic therapy

Inadequate use of antibiotics in the covid-19 era: effectiveness of antibiotic therapy

Abstract Background Since December 2019, the COVID-19 pandemic has changed the concept of medicine. This work aims to analyze the use of antibiotics in patients admitted to the hospital due to SARS-CoV-2 infection. Methods This work analyzes the use and effectiveness of antibiotics in hospitalized p...

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Autores principales: Alejandro David Bendala Estrada, Jorge Calderón Parra, Eduardo Fernández Carracedo, Antonio Muiño Míguez, Antonio Ramos Martínez, Elena Muñez Rubio, Manuel Rubio-Rivas, Paloma Agudo, Francisco Arnalich Fernández, Vicente Estrada Perez, María Luisa Taboada Martínez, Anxela Crestelo Vieitez, Paula Maria Pesqueira Fontan, Marta Bustamante, Santiago J. Freire, Isabel Oriol-Bermúdez, Arturo Artero, Julián Olalla Sierra, María Areses Manrique, H. Francisco Javier Carrasco-Sánchez, Vanessa Carolina Vento, Gema María García García, Pablo Cubero-Morais, José-Manuel Casas-Rojo, Jesús Millán Núñez-Cortés
Formato: article
Lenguaje:EN
Publicado: BMC 2021
Materias:
COVID-19
SARS-CoV-2
Antibiotics
Survival
Macrolides
Azithromycin
Infectious and parasitic diseases
RC109-216
Acceso en línea:https://doaj.org/article/a934fba04e7b4410bb5505c10cacb408
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Sumario:Abstract Background Since December 2019, the COVID-19 pandemic has changed the concept of medicine. This work aims to analyze the use of antibiotics in patients admitted to the hospital due to SARS-CoV-2 infection. Methods This work analyzes the use and effectiveness of antibiotics in hospitalized patients with COVID-19 based on data from the SEMI-COVID-19 registry, an initiative to generate knowledge about this disease using data from electronic medical records. Our primary endpoint was all-cause in-hospital mortality according to antibiotic use. The secondary endpoint was the effect of macrolides on mortality. Results Of 13,932 patients, antibiotics were used in 12,238. The overall death rate was 20.7% and higher among those taking antibiotics (87.8%). Higher mortality was observed with use of all antibiotics (OR 1.40, 95% CI 1.21–1.62; p < .001) except macrolides, which had a higher survival rate (OR 0.70, 95% CI 0.64–0.76; p < .001). The decision to start antibiotics was influenced by presence of increased inflammatory markers and any kind of infiltrate on an x-ray. Patients receiving antibiotics required respiratory support and were transferred to intensive care units more often. Conclusions Bacterial co-infection was uncommon among COVID-19 patients, yet use of antibiotics was high. There is insufficient evidence to support widespread use of empiric antibiotics in these patients. Most may not require empiric treatment and if they do, there is promising evidence regarding azithromycin as a potential COVID-19 treatment.

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