In:
Infection, Springer Science and Business Media LLC, Vol. 50, No. 2 ( 2022-04), p. 423-436
Abstract:
Reported antibiotic use in coronavirus disease 2019 (COVID-19) is far higher than the actual rate of reported bacterial co- and superinfection. A better understanding of antibiotic therapy in COVID-19 is necessary. Methods 6457 SARS-CoV-2-infected cases, documented from March 18, 2020, until February 16, 2021, in the LEOSS cohort were analyzed. As primary endpoint, the correlation between any antibiotic treatment and all-cause mortality/progression to the next more advanced phase of disease was calculated for adult patients in the complicated phase of disease and procalcitonin (PCT) ≤ 0.5 ng/ml. The analysis took the confounders gender, age, and comorbidities into account. Results Three thousand, six hundred twenty-seven cases matched all inclusion criteria for analyses. For the primary endpoint, antibiotic treatment was not correlated with lower all-cause mortality or progression to the next more advanced (critical) phase ( n = 996) (both p 〉 0.05). For the secondary endpoints, patients in the uncomplicated phase ( n = 1195), regardless of PCT level, had no lower all-cause mortality and did not progress less to the next more advanced (complicated) phase when treated with antibiotics ( p 〉 0.05). Patients in the complicated phase with PCT 〉 0.5 ng/ml and antibiotic treatment ( n = 286) had a significantly increased all-cause mortality ( p = 0.029) but no significantly different probability of progression to the critical phase ( p 〉 0.05). Conclusion In this cohort, antibiotics in SARS-CoV-2-infected patients were not associated with positive effects on all-cause mortality or disease progression. Additional studies are needed. Advice of local antibiotic stewardship- (ABS-) teams and local educational campaigns should be sought to improve rational antibiotic use in COVID-19 patients.
Type of Medium:
Online Resource
ISSN:
0300-8126
,
1439-0973
DOI:
10.1007/s15010-021-01699-2
Language:
English
Publisher:
Springer Science and Business Media LLC
Publication Date:
2022
detail.hit.zdb_id:
2006315-5
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