Antibiotic use in patients with COVID-19: a 'snapshot' Infectious Diseases International Research Initiative (ID-IRI) survey
Beovic, Bojana; Dousak, May; Ferreira-Coimbra, Joao; Nadrah, Kristina; Rubulotta, Francesca; Belliato, Mirko; Berger-Estilita, Joana; Ayoade, Folusakin; Rello, Jordi; Erdem, Hakan
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY
2020
VL / 75 - BP / 3386 - EP / 3390
abstract
Background: Antibiotics may be indicated in patients with COVID-19 due to suspected or confirmed bacterial superinfection. Objectives: To investigate antibiotic prescribing practices in patients with COVID-19. Methods: We performed an international web-based survey and investigated the pattern of antibiotic use as reported by physicians involved in treatment of COVID-19. SPSS Statistics version 25 was used for data analysis. Results: The survey was completed by 166 participants from 23 countries and 82 different hospitals. Local guidelines for antibiotic use in COVID-19 patients were reported by 61.8% (n = 102) of participants and for 82.9% (n = 136) they did not differ from Local community-acquired pneumonia guidelines. Clinical presentation was recognized as the most important reason for the start of antibiotics (mean score 4.07 and SD =1.095 on grading scale from 1 to 5). When antibiotics were started, most respondents rated as the highest the need for coverage of atypical pathogens (mean score = 2.8 and SD = 0.99), followed by Staphylococcus aureus (mean score = 2.67 and SD = 1.05 on bi-modal scale, with values 1 and 2 for disagreement and values 3 and 4 for agreement). In the patients on the ward, 29.1% of respondents chose not to prescribe any antibiotic. Combination of beta-Lactams and macrolides or fluoroquinolones was reported by 52.4% (n = 87) of respondents. In patients in the ICU, piperacillin/tazobactam was the most commonly prescribed antibiotic. The mean reported duration of antibiotic treatment was 7.12 (SD = 2.44) days. Conclusions: The study revealed widespread broad-spectrum antibiotic use in patients with COVID-19. Implementation of antimicrobial stewardship principles is warranted to mitigate the negative consequences of antibiotic therapy.
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