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Published on: August 30, 2018
Is there a need to widely prescribe antibiotics in patients hospitalized with COVID-19?
F Moretto1, T Sixt1, H Devilliers2
1Infectious Diseases Department, Dijon University Hospital, Dijon, France.
Insights
Antibiotic use in hospitalized coronavirus disease 2019 (COVID-19) patients was common and linked to severe illness. However, antibiotic therapy did not significantly impact patient outcomes, suggesting a need to optimize antibiotic prescribing for COVID-19.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Pharmacology
Background:
- Wide prescription of antibiotics for hospitalized coronavirus disease 2019 (COVID-19) patients remains debated.
- Assessing the benefits and risks of antibiotic use in this population is crucial.
Purpose of the Study:
- To evaluate the association between antibiotic therapy and outcomes in hospitalized COVID-19 patients.
- To determine if antibiotic use influences mortality or intensive care unit transfer.
Main Methods:
- Retrospective study of 222 hospitalized COVID-19 patients.
- Collected clinical, biological, and radiological data, including treatment and outcomes.
- Utilized propensity score matching to compare outcomes between patients who received antibiotic therapy and those who did not.
Main Results:
- Antibiotics were administered to 78% of patients, who were older, frailer, and presented with more severe disease.
- Univariate analysis showed higher unfavorable outcomes in patients receiving antibiotics (HR 2.94, P=0.04).
- Multivariate analysis and propensity score matching found no significant association between antibiotic therapy and outcomes (HR 1.612, P=0.37).
Conclusions:
- Frequent antibiotic prescription in COVID-19 patients is associated with disease severity but not patient outcomes.
- Data support the need to streamline antibiotic therapy in hospitalized COVID-19 patients.
- Further research may refine antibiotic stewardship guidelines for COVID-19 management.
Background:
Debate continues regarding the usefulness and benefits of wide prescription of antibiotics in patients hospitalized with coronavirus disease 2019 (COVID-19).
Methods:
All patients hospitalized in the Infectious Diseases Department, Dijon University Hospital, Dijon, France between 27 February and 30 April 2020 with confirmed COVID-19 were included in this study. Clinical, biological and radiological data were collected, as well as treatment and outcome data. An unfavourable outcome was defined as death or transfer to the intensive care unit. Patient characteristics and outcomes were compared between patients who did and did not receive antibiotic therapy using propensity score matching.
Findings:
Among the 222 patients included, 174 (78%) received antibiotic therapy. The univariate analysis showed that patients who received antibiotic therapy were significantly older, frailer and had more severe presentation at admission compared with patients who did not receive antibiotic therapy. Unfavourable outcomes were more common in patients who received antibiotic therapy [hazard ratio (HR) 2.94, 95% confidence interval (CI) 1.07-8.11; P = 0.04]. Multi-variate analysis and propensity score matching indicated that antibiotic therapy was not significantly associated with outcome (HR 1.612, 95% CI 0.562-4.629; P = 0.37).
Conclusion:
Antibiotics were frequently prescribed in this study and this was associated with more severe presentation at admission. However, antibiotic therapy was not associated with outcome, even after adjustment. In line with recent publications, such data support the need to streamline antibiotic therapy in patients with COVID-19.
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