Abstract
ABSTRACT.In this study, we described the proportion of COVID-19 patients started on antibiotics empirically and the work-ups performed to diagnose bacterial superinfection. We used a retrospective cohort study design involving medical records of symptomatic, hospitalized COVID-19 patients who were admitted to these centers. A total of 481 patients were included, with a median age of 41.0 years (interquartile range, 28-58.5 years). A total of 72.1% (N = 347) of COVID-19 patients received antibiotics, either before or during admission. This is troublesome because none of the patients’ bacterial culture or inflammatory markers, such as the erythrocyte sedimentation rate or C-reactive protein, were evaluated, and only 73 (15.2%) underwent radiological investigations. Therefore, national COVID-19 guidelines should emphasize the rational use of antibiotics for the treatment of COVID-19, a primarily viral disease. Integrating antimicrobial stewardship into the COVID-19 response and expanding microbiological capacities in low-income countries are indispensable. Otherwise, we risk one pandemic aggravating another.
Highlights
We studied the antibiotic use by COVID-19 patients admitted to four Ethiopian treatment centers between May and November 2020, and assessed the work-up they underwent to diagnose bacterial superinfection
The management of COVID-19 at the treatment centers is in line with the national treatment guidelines
Severe illness is described as severe pneumonia, acute respiratory distress syndrome, or sepsis responding to noninvasive management
Summary
The management of COVID-19 at the treatment centers is in line with the national treatment guidelines. Frequent and often inappropriate antibiotic use is common in low- and middle-income countries.[1] Because of the worldwide increase in antimicrobial resistance, this is concerning. We studied the antibiotic use by COVID-19 patients admitted to four Ethiopian treatment centers between May and November 2020, and assessed the work-up they underwent to diagnose bacterial superinfection. Moderate illness is described as mild pneumonia according to the CURB-65 criteria (absence of confusion, urea, respiratory rate, and blood pressure, and age 65 years or older).
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