Antibiotic Usage in the COVID-19 Intensive Care Unit of an Infectious Diseases Hospital from Nord-Eastern Romania

Vâţă, A; Roşu, Florin Manuel; Dorneanu, Olivia; Lehaci, Alina Elisabeta; Luca, Ștefana; Loghin, Isabela Ioana; Miftode, Ioana Diandra; Luca, Cătălina; Miftode, Egidia

doi:10.3390/medicina59040645

Cited by 3 publications

(2 citation statements)

References 62 publications

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“…36 Another study of eastern Romania revealed that linezolid were the most prescribed antibiotics (77.2%), while imipenem (75.5%) and ceftriaxone (33.7%) followed by. 37 Several individuals are significantly inclined to develop tiny blood emboli in their lungs as a consequence of COVID-19, which can cause acute respiratory distress syndrome, a symptom of severe COVID-19 diseases, and lead to death. 38 Anticoagulants such as enoxaparin, unfractionated heparin, and rivaroxaban are often given to COVID-19 patients as part of their treatment.…”

Section: Resultsmentioning

confidence: 99%

Prescription patterns in an intensive care unit of COVID‐19 patients in Bangladesh: A cross‐sectional study

Rahman,

Islam,

Paul

et al. 2023

Health Science Reports

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Background and AimsTo reduce death rates for critical patients hospitalized in intensive care units (ICUs), coronavirus (COVID‐19) lacks proven and efficient treatment methods. This cross‐sectional study aims to evaluate how physicians treat severe and suspected COVID‐19 patients in the ICU department in the absence of an established approach, as well as assess the rational use of the medication in the ICU department.MethodsBetween June 16, 2021, and December 10, 2022, a total of 428 prescriptions were randomly gathered, including both suspected (yellow zone) and confirmed (red zone) COVID‐19 patients. For data management, Microsoft Excel 2021 was utilized, while STATA 17 provided statistical analysis. To find associations between patients' admission status and demographic details, exploratory and bivariate analyses were conducted.ResultsOf the 428 patients admitted to the ICU, 228 (53.27%) were in the yellow zone and 200 (46.73%) were in the verified COVID‐19 red zone. The majority of patients were male (54.44%), and the age range from 41 to 60 was the most common (41.82%). No significant deviation was detected to the yellow and red groups' prescription patterns. A total of 4001 medicines (mean 9.35/patient) were prescribed. Antiulcerants, antibiotics, respiratory, analgesics, anticoagulants, vitamins and minerals, steroids, cardiovascular, antidiabetic drugs, antivirals, antihistamines, muscle relaxants, and antifungal treatments were widely prescribed drugs. Enoxaparin (67.06%) appeared as the most prescribed medicine, followed by montelukast (60.51%), paracetamol (58.41%), and dexamethasone (51.64%).ConclusionThe prescription patterns for the yellow and red groups were comparable and mostly included symptomatic treatment. Respiratory drugs constituted the most frequent therapeutic class. Polypharmacy should be taken under considerations. In ICU settings, the outcomes emphasize the need of correct diagnosis, cautious antibiotic usage, suitable therapy, and attentive monitoring.

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Section: Resultsmentioning

confidence: 99%

Prescription patterns in an intensive care unit of COVID‐19 patients in Bangladesh: A cross‐sectional study

Rahman,

Islam,

Paul

et al. 2023

Health Science Reports

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“…Regarding irrational antibiotic use, the COVID-19 pandemic was not an exception. Several studies have evaluated antibiotic use during the pandemic [29,30]. Vâţă et al conducted a retrospective study to assess antibiotic use practices in critically ill patients.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Serial Procalcitonin Levels for the Optimization of Antibiotic Use in Non-Critically Ill COVID-19 Patients

Almulhim,

Alabdulwahed,

Aldoughan

et al. 2024

Pharmaceuticals

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Background: Procalcitonin (PCT) has been used as a biomarker to guide antibiotic therapy in various patient populations. However, its role in optimizing antibiotic use in COVID-19 patients has not been well studied to date. Thus, we aimed to evaluate the use of serial PCT monitoring as an antimicrobial stewardship tool for COVID-19 patients. Methods: This retrospective study included 240 COVID-19 patients who were admitted to a tertiary medical institution in Saudi Arabia between January 2020 and February 2022. Patients who received empiric antibiotic therapy for community-acquired pneumonia (CAP) and had serial procalcitonin levels were included. The patients were divided into two groups: the normal procalcitonin arm (PCT level < 0.5 ng/mL) and the elevated PCT arm (PCT level > 0.5 ng/mL). The primary and secondary outcomes were the effect of PCT monitoring on the duration of antibiotic exposure and the length of hospital stay, respectively. To measure the accuracy of PCT, the receiver-operating characteristic area under the curve (ROC-AUC) was determined. Results: Among the included patients, 142 were in the normal procalcitonin arm (median PCT, 0.12 ng/mL), and 78 were in the elevated PCT arm (median PCT, 4.04 ng/mL). The baseline characteristics were similar between the two arms, except for the higher prevalence of kidney disease in the elevated PCT arm. There was no statistically significant difference in the duration of antibiotic exposure between the normal and elevated PCT arms (median duration: 7 days in both arms). However, the length of hospital stay was significantly shorter in the normal PCT arm (median stay, 9 days) than in the elevated PCT arm (median stay, 13 days; p = 0.028). The ROC-AUC value was 0.54 (95% CI: 0.503–0.595). Conclusions: Serial PCT monitoring did not lead to a reduction in the duration of antibiotic exposure in COVID-19 patients. However, it was associated with a shorter hospital stay. These findings suggest that PCT monitoring may be useful for optimizing antibiotic use and improving outcomes in COVID-19 patients. While PCT-guided algorithms have the potential to enable antibiotic stewardship, their role in the context of COVID-19 treatment requires further investigation.

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Bacterial Infections, Trends, and Resistance Patterns in the Time of the COVID-19 Pandemic in Romania—A Systematic Review

Vulcanescu,

Bagiu,

Avram

et al. 2024

Antibiotics

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Background: The COVID-19 pandemic has intensified concerns over bacterial infections and antimicrobial resistance, particularly in Romania. This systematic review explores bacterial infection patterns and resistance during the pandemic to address critical gaps in knowledge. Methods: A systematic review, following PRISMA guidelines, was conducted using databases such as PubMed and Scopus, focusing on studies of bacterial infections from 2020 to 2022. Articles on bacterial infections in Romanian patients during the pandemic were analyzed for demographic data, bacterial trends, and resistance profiles. Results: A total of 87 studies were included, detailing over 20,000 cases of bacterial infections. The review found that Gram-negative bacteria, particularly Escherichia coli and Klebsiella pneumoniae, were the most frequently identified pathogens, alongside Gram-positive Staphylococcus aureus and Enterococcus spp. Multidrug resistance (MDR) was noted in 24% of the reported strains, with common resistance to carbapenems and cephalosporins. Conclusions: The pandemic has amplified the complexity of managing bacterial infections, particularly in critically ill patients. The rise in MDR bacteria underscores the need for stringent antimicrobial stewardship and infection control measures. Continuous monitoring of bacterial trends and resistance profiles will be essential to improve treatment strategies in post-pandemic healthcare settings.

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Antibiotic Usage in the COVID-19 Intensive Care Unit of an Infectious Diseases Hospital from Nord-Eastern Romania

Cited by 3 publications

References 62 publications

Prescription patterns in an intensive care unit of COVID‐19 patients in Bangladesh: A cross‐sectional study

Prescription patterns in an intensive care unit of COVID‐19 patients in Bangladesh: A cross‐sectional study

Evaluation of Serial Procalcitonin Levels for the Optimization of Antibiotic Use in Non-Critically Ill COVID-19 Patients

Bacterial Infections, Trends, and Resistance Patterns in the Time of the COVID-19 Pandemic in Romania—A Systematic Review

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