Empiric Antibiotics in COVID 19: A Narrative Review

Lingas, Elvina C

doi:10.7759/cureus.25596

Cited by 9 publications

(8 citation statements)

References 62 publications

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“…Several studies show conflicting evidence on the correlation between hospital infections caused by MDR pathogens and COVID-19. This happens because a wide use of empirical antibiotic therapy in patients affected by COVID-19 could be related to an increase in resistance in microorganisms [ 51 , 52 ]. However, other authors have found a reduction in infections caused by MDR organisms in this period when compared to the pre-pandemic period.…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial Resistance in Pseudomonas aeruginosa before and during the COVID-19 Pandemic

et al. 2023

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Pseudomonas aeruginosa (PA) is a major Gram-negative opportunistic pathogen causing several serious acute and chronic infections in the nosocomial and community settings. PA eradication has become increasingly difficult due to its remarkable ability to evade antibiotics. Therefore, epidemiological studies are needed to limit the infection and aim for the correct treatment. The present retrospective study focused on PA presence among samples collected at the San Giovanni di Dio and Ruggi D’Aragona University Hospital in Salerno, Italy; its resistance profile and relative variations over the eight years were analyzed. Bacterial identification and antibiotic susceptibility tests were performed by VITEK® 2. In the 2015–2019 and 2020–2022 timeframes, respectively, 1739 and 1307 isolates of PA were obtained from respiratory samples, wound swabs, urine cultures, cultural swabs, blood, liquor, catheter cultures, vaginal swabs, and others. During 2015–2019, PA strains exhibited low resistance against amikacin (17.2%), gentamicin (25.2%), and cefepime (28.3%); moderate resistance against ceftazidime (34.4%), imipenem (34.6%), and piperacillin/tazobactam (37.7%); and high resistance against ciprofloxacin (42.4%) and levofloxacin (50.6%). Conversely, during the 2020–2022 era, PA showed 11.7, 21.1, 26.9, 32.6, 33.1, 38.7, and 39.8% resistance to amikacin, tobramycin, cefepime, imipenem, ceftazidime, ciprofloxacin, and piperacillin/tazobactam, respectively. An overall resistance-decreasing trend was observed for imipenem and gentamicin during 2015–2019. Instead, a significant increase in resistance was recorded for cefepime, ceftazidime, and imipenem in the second set of years investigated. Monitoring sentinel germs represents a key factor in optimizing empirical therapy to minimize the spread of antimicrobial resistance.

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Section: Discussionmentioning

confidence: 99%

Antimicrobial Resistance in Pseudomonas aeruginosa before and during the COVID-19 Pandemic

et al. 2023

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“…114 Numerous studies of COVID-19 patients admitted to the ICU show that most patients were empirically administered antibiotics, increasing the prevalence of MDR pathogens. 114,115 Prevalence of MDR Gram-negative bacteria is also attributed to improper compliance of hand hygiene and contact isolation, such as glove and gown usage, by hospital staff. 116 Moreover, given that such errors also increase HAP and VAP occurrence among COVID-19 patients, specific infection prevention strategies (such as preventing reintubation, minimizing sedation, providing early enteral nutrition, among others) have become increasingly pivotal to implement.…”

Section: Mdr Gram-negative Pathogens Causing Pneumonia In Covid-19 Pa...mentioning

confidence: 99%

Hospital-acquired and ventilator-associated pneumonia caused by multidrug-resistant Gram-negative pathogens: Understanding epidemiology, resistance patterns, and implications with COVID-19

Hammoudi Halat,

Ayoub Moubareck

2024

F1000Res

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The ongoing spread of antimicrobial resistance has complicated the treatment of bacterial hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP). Gram-negative pathogens, especially those with multidrug-resistant profiles, including Escherichia coli, Klebsiella pneumoniae, Enterobacter spp., Pseudomonas aeruginosa, and Acinetobacter spp., are important culprits in this type of infections. Understanding the determinants of resistance in pathogens causing pneumonia is ultimately stressing, especially in the shadows of the COVID-19 pandemic, when bacterial lung infections are considered a top priority that has become urgent to revise. Globally, the increasing prevalence of these pathogens in respiratory samples represents a significant infection challenge, with major limitations of treatment options and poor clinical outcomes. This review will focus on the epidemiology of HAP and VAP and will present the roles and the antimicrobial resistance patterns of implicated multidrug-resistant (MDR) Gram-negative pathogens like carbapenem-resistant Acinetobacter baumannii (CRAB), carbapenem-resistant Pseudomonas aeruginosa (CRPA), carbapenem-resistant Enterobacterales (CRE), as well as colistin-resistant Gram-negative pathogens and extended-spectrum β-lactamase (ESBL)-producing Enterobacterales. While emerging from the COVID-19 pandemic, perspectives and conclusions are drawn from findings of HAP and VAP caused by MDR Gram-negative bacteria in patients with COVID-19.

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“…111 Numerous studies of COVID-19 patients admitted to the ICU show that most patients were empirically administered antibiotics, increasing the prevalence of MDR pathogens. 111,112 In general, the rates of VAP in patients with COVID-19 who were critically ill was reported to rise above 50%, [113][114][115][116][117] with an estimated mortality exceeding 40%, and an increase in the number of patients requiring intensive care. 118 In a multicenter study, VAP accounted for 50% of all hospital-acquired infections in patients with COVID-19, with 28% prevalence of Gram-negative pathogens as agents in VAP.…”

Section: Carbapenem-resistant Enterobacterales (Cre)mentioning

confidence: 99%

Bacterial pneumonia associated with multidrug-resistant Gram-negative pathogens: Understanding epidemiology, resistance patterns, and implications with COVID-19

Halat

Moubareck

2023

F1000Res

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The ongoing spread of antimicrobial resistance has complicated the treatment of bacterial hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP). Gram-negative pathogens, especially those with multidrug-resistant profiles, including Escherichia coli, Klebsiella pneumoniae, Enterobacter spp., Pseudomonas aeruginosa, and Acinetobacter spp., are an important culprit in this type of infections. Understanding the determinants of resistance in pathogens causing pneumonia is ultimately stressing, especially in the shadows of the COVID-19 pandemic, when bacterial lung infections are considered a top priority that has become urgent to revise. Globally, the increasing prevalence of these pathogens in respiratory samples represents a significant infection challenge, with major limitations of treatment options and poor clinical outcomes. This review will focus on the epidemiology of HAP and VAP and will present the roles and the antimicrobial resistance patterns of implicated multidrug-resistant (MDR) Gram-negative pathogens like carbapenem-resistant Acinetobacter baumannii (CRAB), carbapenem-resistant Pseudomonas aeruginosa (CRPA), carbapenem-resistant Enterobacterales (CRE), as well as colistin-resistant Gram-negative pathogens and extended-spectrum β-lactamase (ESBL)-producing Enterobacterales. While emerging from the COVID-19 pandemic, perspectives and conclusions are drawn from findings of HAP and VAP caused by MDR Gram-negative bacteria in patients with COVID-19.

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Empiric Antibiotics in COVID 19: A Narrative Review

Cited by 9 publications

References 62 publications

Antimicrobial Resistance in Pseudomonas aeruginosa before and during the COVID-19 Pandemic

Antimicrobial Resistance in Pseudomonas aeruginosa before and during the COVID-19 Pandemic

Hospital-acquired and ventilator-associated pneumonia caused by multidrug-resistant Gram-negative pathogens: Understanding epidemiology, resistance patterns, and implications with COVID-19

Bacterial pneumonia associated with multidrug-resistant Gram-negative pathogens: Understanding epidemiology, resistance patterns, and implications with COVID-19

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