High rates of antibiotic prescriptions in children with COVID‐19 or multisystem inflammatory syndrome: A multinational experience in 990 cases from Latin America

Abstract

Aim: This study aims to assess rates of antibiotic prescriptions and its determinants in in children with COVID-19 or Multisystem Inflammatory Syndrome (MIS-C).Methods: Children <18 years-old assessed in five Latin Americas countries with a diagnosis of COVID-19 or MIS-C were enrolled. Antibiotic prescriptions and factors associated with their use were assessed. Results: A total of 990 children were included: 921 (93%) with COVID-19, 69 (7.0%) with MIS-C. The prevalence of antibiotic use was 24.5% (n = 243). MIS-C with (OR = 45.48) or without (OR = 10.35) cardiac involvement, provision of intensive care (OR = 9.60), need for hospital care (OR = 6.87), pneumonia and/or ARDS detected through chest X-rays (OR = 4.40), administration of systemic corticosteroids (OR = 4.39), oxygen support, mechanical ventilation or CPAP (OR = 2.21), pyrexia How to cite this article: Yock-Corrales A, Lenzi J, Ulloa-Gutiérrez R, et al. High rates of antibiotic prescriptions in children with COVID-19 or multisystem inflammatory syndrome: A multinational experience in 990 cases from Latin

Antibiotic Prescribing in Children Hospitalized With COVID-19 and Multisystem Inflammatory Syndrome in Spain: Prevalence, Trends, and Associated Factors

“…To the best of our knowledge, this is the largest study analyzing antibiotic prescribing and concomitant bacterial infection in hospitalized children with COVID-19 or MIS-C. About half (54.2%) of all patients in our cohort received systemic antibiotics during admission, which is higher than that reported by Yock-Corrales et al [ 10 ] (24.5%; 243/990 children) in a Latin American cohort including both outpatients and inpatients. Our reported rate is lower than the 69% (415/601) described by Swann et al [ 9 ] in hospitalized children in the United Kingdom, perhaps because our study was longer term (until March 2021 vs July 2020), with increasing evidence of low bacterial coinfection in COVID-19.…”

“…Specific data on children are scarce [ 9 , 10 ]. Expanding our knowledge of antibiotic prescribing patterns in the COVID-19 pediatric population could help to develop and implement ASPs, leading to more judicious use of antibiotics.…”

COVID-19 and Antimicrobial Resistance: Data from the Greek Electronic System for the Surveillance of Antimicrobial Resistance—WHONET-Greece (January 2018–March 2021)

“…Similar findings of multi-drug-resistant A. baumannii isolates have been recently mentioned elsewhere in COVID-19 patients in both blood and respiratory isolates, mainly from ICUs in high percentages [ 51 , 52 ]. High rates of resistance were observed in almost all widely used antibiotics in A. baumannii infections, such as carbapenems/meropenem [ 27 , 53 , 54 ], other β-lactams [ 19 , 55 ], aminoglycosides/amikacin [ 19 , 27 , 30 , 54 ] and colistin [ 52 , 53 ]. Tigecycline was also reported to be used in COVID-19 patients with A. baumannii co-infections; susceptible isolates reported in Li et al, 2020 [ 27 ] and Kyriakidis et al [ 52 ]; and resistant isolates in Vijay et al [ 56 ] and Chen et al [ 30 ].…”

Association between Coagulation Profile and Clinical Outcome in Children with SARS-CoV-2 Infection or MIS-C: A Multicenter Cross-Sectional Study

“…This decision was based on the possibility of Latin American centers to perform blood tests, including coagulation profile, only in the most ill children. These four centers have been selected as part of the COVID-DOMINGO network, which already published several studies in the field of pediatric COIVD-19 [ 16 , 17 , 18 , 19 , 20 ]. Epidemiological, demographic, clinical, laboratory data and information concerning treatment and clinical outcomes were collected by an operator in each hospital and entered into an electronic database built on purpose for the present study and subsequently used for statistical analysis.…”