Abstract
BackgroundSince December 2019, the COVID-19 pandemic has changed the concept of medicine. This work aims to analyze the use of antibiotics in patients admitted to the hospital due to SARS-CoV-2 infection.MethodsThis work analyzes the use and effectiveness of antibiotics in hospitalized patients with COVID-19 based on data from the SEMI-COVID-19 registry, an initiative to generate knowledge about this disease using data from electronic medical records. Our primary endpoint was all-cause in-hospital mortality according to antibiotic use. The secondary endpoint was the effect of macrolides on mortality.ResultsOf 13,932 patients, antibiotics were used in 12,238. The overall death rate was 20.7% and higher among those taking antibiotics (87.8%). Higher mortality was observed with use of all antibiotics (OR 1.40, 95% CI 1.21–1.62; p < .001) except macrolides, which had a higher survival rate (OR 0.70, 95% CI 0.64–0.76; p < .001). The decision to start antibiotics was influenced by presence of increased inflammatory markers and any kind of infiltrate on an x-ray. Patients receiving antibiotics required respiratory support and were transferred to intensive care units more often.ConclusionsBacterial co-infection was uncommon among COVID-19 patients, yet use of antibiotics was high. There is insufficient evidence to support widespread use of empiric antibiotics in these patients. Most may not require empiric treatment and if they do, there is promising evidence regarding azithromycin as a potential COVID-19 treatment.
Highlights
In late December 2019, a series of pneumonia cases of an unknown etiology were diagnosed in Wuhan, Hubei province (China)
A higher mortality rate was observed with the use of all antibiotics except macrolides, which showed a higher survival rate
Differences in fatality have been noted according to where the virus was acquired: mortality was higher among those who acquired the infection nosocomially or in a nursing home compared to those who were infected in the community (Table 4)
Summary
Background In late December 2019, a series of pneumonia cases of an unknown etiology were diagnosed in Wuhan, Hubei province (China). A new Bendala Estrada et al BMC Infect Dis (2021) 21:1144 pandemic, with more than 3,500,000 cases and 79,000 deaths as of that date [3,4,5]. Physicians are using drugs approved for other indications while others are being studied. In this context, this work reflects on how to approach the challenge of treating this illness, in regard to the use of antibiotics [9, 10]. Since December 2019, the COVID-19 pandemic has changed the concept of medicine. This work aims to analyze the use of antibiotics in patients admitted to the hospital due to SARS-CoV-2 infection
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