抗生素治疗患者住院治疗不严重的COVID-19
Michael S Pulia1,2, Meggie Griffin1, Rebecca Schwei1
1BerbeeWalsh Department of Emergency Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison.
对不严重的COVID-19早期抗生素治疗没有改善患者的结果. 由于风险和抗生素耐药性问题,应避免在这些患者中不必要使用社区获得性肺炎 (CAP) 的抗生素.
科学领域:
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
背景情况:
- 在不严重的COVID-19患者中,过度使用社区获得性肺炎 (CAP) 的抗生素是常见的,尽管细菌共感染率低.
- 不必要的抗生素处方有助于抗菌素耐药性和伤害患者.
研究的目的:
- 调查早期CAP抗生素治疗与住院的不重症COVID-19患者的临床结果之间的关联.
- 评估抗生素使用对患者病情恶化和住院死亡率的影响.
主要方法:
- 使用目标试验仿真设计的回顾性队列研究.
- 包括在1053家美国医院中为不严重的COVID-19住院的超过52万名成年患者.
- 使用倾向方法来评估CAP抗生素暴露与主要结果之间的关联,并对混因素进行调整.
主要成果:
- 30.8%的患者在入院时接受了CAP抗生素.
- 主要综合结局 (恶化或死亡率) 在抗生素组略高 (20.8%对18.4%),但没有临床意义.
- 接受CAP抗生素的患者在统计学上更有可能出现不良的临床结果 (ORs从1.03到1.10不等).
结论:
- 对不严重的COVID-19的早期抗生素治疗在这个大队伍中没有显示出临床上有意义的益处.
- 研究结果表明,在这种人群中,常规使用抗生素是不必要的,应该阻止.
- 避免不必要的抗生素对于打击抗菌素耐药性和保护患者安全至关重要.
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