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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spelling	oai:doaj.org-article:a934fba04e7b4410bb5505c10cacb4082021-11-14T12:44:23ZInadequate use of antibiotics in the covid-19 era: effectiveness of antibiotic therapy10.1186/s12879-021-06821-11471-2334https://doaj.org/article/a934fba04e7b4410bb5505c10cacb4082021-11-01T00:00:00Zhttps://doi.org/10.1186/s12879-021-06821-1https://doaj.org/toc/1471-2334Abstract 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.Alejandro David Bendala EstradaJorge Calderón ParraEduardo Fernández CarracedoAntonio Muiño MíguezAntonio Ramos MartínezElena Muñez RubioManuel Rubio-RivasPaloma AgudoFrancisco Arnalich FernándezVicente Estrada PerezMaría Luisa Taboada MartínezAnxela Crestelo VieitezPaula Maria Pesqueira FontanMarta BustamanteSantiago J. FreireIsabel Oriol-BermúdezArturo ArteroJulián Olalla SierraMaría Areses ManriqueH. Francisco Javier Carrasco-SánchezVanessa Carolina VentoGema María García GarcíaPablo Cubero-MoraisJosé-Manuel Casas-RojoJesús Millán Núñez-CortésBMCarticleCOVID-19SARS-CoV-2AntibioticsSurvivalMacrolidesAzithromycinInfectious and parasitic diseasesRC109-216ENBMC Infectious Diseases, Vol 21, Iss 1, Pp 1-23 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	COVID-19 SARS-CoV-2 Antibiotics Survival Macrolides Azithromycin Infectious and parasitic diseases RC109-216
spellingShingle	COVID-19 SARS-CoV-2 Antibiotics Survival Macrolides Azithromycin Infectious and parasitic diseases RC109-216 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 Inadequate use of antibiotics in the covid-19 era: effectiveness of antibiotic therapy
description	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.
format	article
author	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
author_facet	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
author_sort	Alejandro David Bendala Estrada
title	Inadequate use of antibiotics in the covid-19 era: effectiveness of antibiotic therapy
title_short	Inadequate use of antibiotics in the covid-19 era: effectiveness of antibiotic therapy
title_full	Inadequate use of antibiotics in the covid-19 era: effectiveness of antibiotic therapy
title_fullStr	Inadequate use of antibiotics in the covid-19 era: effectiveness of antibiotic therapy
title_full_unstemmed	Inadequate use of antibiotics in the covid-19 era: effectiveness of antibiotic therapy
title_sort	inadequate use of antibiotics in the covid-19 era: effectiveness of antibiotic therapy
publisher	BMC
publishDate	2021
url	https://doaj.org/article/a934fba04e7b4410bb5505c10cacb408
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Inadequate use of antibiotics in the covid-19 era: effectiveness of antibiotic therapy

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