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

BMC Infectious Diseases

Isabel Oriol-Bermúdez¹  Paloma Agudo²  Santiago J. Freire³  Gema María García García⁴  Manuel Rubio-Rivas⁵  María Luisa Taboada Martínez⁶  Julián Olalla Sierra⁷  Arturo Artero⁸  Antonio Muiño Míguez⁹  Jesús Millán Núñez-Cortés⁹  Alejandro David Bendala Estrada⁹  Eduardo Fernández Carracedo⁹  Vanessa Carolina Vento^1,10  José-Manuel Casas-Rojo^1,11  H. Francisco Javier Carrasco-Sánchez^1,12  Francisco Arnalich Fernández^1,13  Marta Bustamante^1,14  Elena Muñez Rubio^1,15  Jorge Calderón Parra^1,15  Antonio Ramos Martínez^1,15  Anxela Crestelo Vieitez^1,16  Pablo Cubero-Morais^1,17  Vicente Estrada Perez^1,18  María Areses Manrique^1,19  Paula Maria Pesqueira Fontan^2,20 

[1] Infectious Diseases, Internal Medicine Department, Moisès Broggi Hospital;Internal Medicine Department, 12 de Octubre University Hospital;Internal Medicine Department, A Coruña University Hospital;Internal Medicine Department, Badajoz University Hospital Complex;Internal Medicine Department, Bellvitge University Hospital-IDIBELL;Internal Medicine Department, Cabueñes University Hospital;Internal Medicine Department, Costa del Sol Hospital;Internal Medicine Department, Dr. Peset University Hospital;Internal Medicine Department, Gregorio Marañón General University Hospital;Internal Medicine Department, Henares Hospital;Internal Medicine Department, Infanta Cristina University Hospital;Internal Medicine Department, Juan Ramón Jiménez University Hospital;Internal Medicine Department, La Paz University Hospital;Internal Medicine Department, La Princesa University Hospital;Internal Medicine Department, Puerta de Hierro Majadahonda University Hospital;Internal Medicine Department, Royo Villanova Hospital;Internal Medicine Department, Río Hortega University Hospital;Internal Medicine Department, San Carlos Clinical Hospital;Internal Medicine Department, Santa Marina Hospital;Internal Medicine Department, Santiago Clinical Hospital;

关键词: COVID-19;    SARS-CoV-2;    Antibiotics;    Survival;    Macrolides;    Azithromycin;   

DOI  :  10.1186/s12879-021-06821-1

来源: DOAJ

【 摘 要 】

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.

【 授权许可】

Unknown