Outcomes and antibiotic use in patients with coronavirus disease 2019 (COVID-19) admitted to an intensive care unit

Petteys, Megan; Medaris, Leigh Ann; Williamson, Julie; Soman, Rohit; Denmeade, Travis; Anderson, William E.; Leonard, Michael; Polk, Christopher

doi:10.1017/ash.2021.248

Cited by 2 publications

(3 citation statements)

References 10 publications

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“…Since the beginning of the pandemic, national authorities have strongly discouraged the use of antibiotics for COVID-19. As amply demonstrated by numerous well-conducted clinical studies, there is no evidence that the use of antibiotics has a protective effect on the evolution of COVID-19 including mortality, as clearly stated by all international guidelines for the treatment of SARS-CoV-2 infection [37][38][39][40]. Since antibiotics probably do not provide a benefit as an empirical treatment in COVID-19 and are associated with undesirable consequences, including adverse events, toxicity, resistance and clostridioides difficile infections, it is prudent for physicians to prescribe them judiciously.…”

Section: Discussionmentioning

confidence: 99%

Epidemiological Impact on Use of Antibiotics in Patients Hospitalized for COVID-19: A Retrospective Cohort Study in Italy

Maraia,

Mazzoni,

Turtora

et al. 2023

Antibiotics

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The increased incidence of antimicrobial resistance during coronavirus disease 2019 (COVID-19) is a very important collateral damage of global concern. The cause is multifactorial and is particularly related to the high rates of antibiotic use in COVID-19 patients with a relatively low rate of secondary co-infection. To this end, we conducted a retrospective observational study of 1269 COVID-19 patients admitted during the years 2020, 2021 and 2022 in two Italian hospitals, with a focus on bacterial co-infections and antimicrobial therapy. Multivariate logistic regression was used to analyze the association between bacterial co-infection, antibiotic use and hospital death after adjustment for age and comorbidity. Bacterial co-infection was detected in 185 patients. The overall mortality rate was 25% (n = 317). Concomitant bacterial infections were associated with increased hospital mortality (β = 1.002, p < 0.001). A total of 83.7% (n = 1062) of patients received antibiotic therapy, but only 14.6% of these patients had an obvious source of bacterial infection. There was a significantly higher rate of hospital mortality in patients who received antibiotics than in those who did not (χ2 = 6.22, p = 0.012). Appropriate prescribing and the rational use of antimicrobials according to the principles of antimicrobial stewardship can help prevent the emergence of antibiotic resistance.

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Section: Discussionmentioning

confidence: 99%

Epidemiological Impact on Use of Antibiotics in Patients Hospitalized for COVID-19: A Retrospective Cohort Study in Italy

Maraia,

Mazzoni,

Turtora

et al. 2023

Antibiotics

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“…Nearly three-quarters of COVID-19 patients receive irrational antibiotic therapy, despite the prevalence of bacterial coinfections being as low as <10% in some studies and ranging from 8-22% among ICU patients. 2,3 The Indonesian COVID-19 guidelines recommend empiric antibiotic therapy for severe and critical cases of COVID-19 and do not recommend its use in mild to moderate cases unless there is suspicion of bacterial infection. The choice and duration of empiric antibiotic therapy align with community-acquired pneumonia treatment guidelines.…”

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confidence: 99%

“…Figure 1: Research flow hospitalization and admission to the intensive care unit (ICU). 1 COVID-19 patients undergoing treatment in the ICU are susceptible to hospital-acquired infections due to invasive interventions, such as mechanical ventilation, central venous catheters, and Foley catheters, which can elevate the risk of hospital-associated infections (HAI).Nearly three-quarters of COVID-19 patients receive irrational antibiotic therapy, despite the prevalence of bacterial coinfections being as low as <10% in some studies and ranging from 8-22% among ICU patients 2,3. …”

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confidence: 99%

Rationality of antibiotic use in COVID-19 patients in the ICU of Dr. Hasan Sadikin General Hospital, Bandung; a cohort study

Oktaliansah,

Munazat

2024

Anaesth. pain intensive care

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Background and Objectives: Nearly three-quarters of the patients with COVID-19 received antibiotic therapy despite the bacterial coinfection being only less than 10% in many studies and ranging from 8-22% in ICU patients. The use of broad-spectrum antibiotics in COVID-19 patients has not been proven effective. Overuse of antibiotics may be associated with side effects and antibiotic resistance. The purpose of this study was to determine the antibiotic rationality in COVID-19 patients in the ICU of Dr. Hasan Sadikin Hospital, Bandung, Indonesia. Methodology: This descriptive, retrospective cohort study was carried out by analyzing medical records of COVID-19 patients admitted in the ICU of Dr. Hasan Sadikin Hospital from January-June 2021. Results: There were 138 patients who met the inclusion criteria. A total of 126 (91.3%) patients received antibiotics. A total of 12 (8.7%) severe/critical patients did not receive antibiotics and 79 (62.70%) received inappropriate antibiotic duration. Inappropriate regimen was found in 59 patients (74.68%) with COVID-19 without HAP/VAP and 15 patients (31.92%) with HAP/VAP. The primary issue identified was the inappropriate regimen of antibiotics, Gyssens category 4a. Conclusion: This study concludes that 23.02% patients used rational empirical antibiotics and 45.98% used rational definitive antibiotics in COVID-19 patients in the ICU at RSUP Dr. Hasan Sadikin Bandung during January-June 2021. Abbreviations: ACE- Angiotensin Converting Enzyme; ICU- Intensive Care Unit; HAI- Hospital-Associated Infections; HAP- Hospital-Acquired Pneumonia; IDSA- Infectious Diseases Society of America VAP- Ventilator-Associated Pneumonia Key words: Antibiotics; Antimicrobial Resistance; COVID-19; Intensive Care Units; Prescribing Pattern Citation: Indriasari, Oktaliansah E, Munazat RI. Rationality of antibiotic use in COVID-19 patients in the ICU of Dr. Hasan Sadikin General Hospital Bandung; a cohort study. Anaesth. pain intensive care 2024;28(1):115−125. DOI: 10.35975/apic.v28i1.2384 Received: November 20, 2023; Reviewed: December 03, 2023; Accepted: December 26, 2023

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Outcomes and antibiotic use in patients with coronavirus disease 2019 (COVID-19) admitted to an intensive care unit

Cited by 2 publications

References 10 publications

Epidemiological Impact on Use of Antibiotics in Patients Hospitalized for COVID-19: A Retrospective Cohort Study in Italy

Epidemiological Impact on Use of Antibiotics in Patients Hospitalized for COVID-19: A Retrospective Cohort Study in Italy

Rationality of antibiotic use in COVID-19 patients in the ICU of Dr. Hasan Sadikin General Hospital, Bandung; a cohort study

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