Decreased survival in children inpatients with COVID-19 and antibiotic prescription

BMC Infectious Diseases

Agustin Lugo-Radillo¹  Miguel Huerta²  Xóchitl Trujillo²  Efrén Murillo-Zamora³  Oliver Mendoza-Cano⁴  Mónica Ríos-Silva⁵ 

[1] CONACYT - Facultad de Medicina y Cirugía, Universidad Autónoma Benito Juárez de Oaxaca;Centro Universitario de Investigaciones Biomédicas, Universidad de Colima;Departamento de Epidemiología, Unidad de Medicina Familiar No. 19, Instituto Mexicano del Seguro Social;Facultad de Ingeniería Civil, Universidad de Colima;Universidad de Colima - CONACyT, Centro Universitario de Investigaciones Biomédicas;

关键词: COVID-19;    Child;    Hospitalized;    Anti-bacterial agents;    Drug prescriptions;    Fatal outcome;   

DOI  :  10.1186/s12879-022-07516-x

来源: DOAJ

【 摘 要 】

Abstract Background The empirical prescription of antibiotics to inpatients with Coronavirus Disease 2019 (COVID-19) is frequent despite uncommon bacterial coinfections. Current knowledge of the effect of antibiotics on the survival of hospitalized children with COVID-19 is limited. Objective To characterize the survival experience of children with laboratory-positive COVID-19 in whom antibiotics were prescribed at hospital admission. Methods A retrospective cohort study was conducted in Mexico, with children hospitalized due to COVID-19 from March 2020 to December 2021. Data from 1601 patients were analyzed using the Kaplan–Meier method and the log-rank test. We computed hazard ratios (HR) and 95% confidence intervals (CI) to evaluate the effect of the analyzed exposures on disease outcomes. Results Antibiotics were prescribed to 13.2% ( $$n$$ n = 211) of enrolled children and a higher mortality rate [14.9 (95% CI 10.1–19.8) vs. 8.3 (95% CI 6.8–9.8)] per 1000 person-days, $$p$$ p < 0.001) was found among them. At any given cut-off, survival functions were lower in antibiotic-positive inpatients ( $$p$$ p < 0.001). In the multiple model, antibiotic prescription was associated with a 50% increase in the risk of fatal outcome (HR = 1.50, 95% CI 1.01–2.22). A longer interval between illness onset and healthcare-seeking and pneumonia at hospital admission was associated with a poorer prognosis. Conclusions Our results suggest that antibiotic prescription in children hospitalized due to COVID-19 is associated with decreased survival. If later replicated, these findings highlight the need for rational antibiotics in these patients.

【 授权许可】

Unknown