Lower antibiotic prescription rates in hospitalized COVID-19 patients than influenza patients, a prospective study.

Autor: Fjelltveit EB; Influenza Centre, Department of Clinical Science, University of Bergen, Bergen, Norway.; Department of Microbiology, Haukeland University Hospital, Bergen, Norway., Cox RJ; Influenza Centre, Department of Clinical Science, University of Bergen, Bergen, Norway.; Department of Microbiology, Haukeland University Hospital, Bergen, Norway., Kittang BR; Department of Clinical Science, University of Bergen, Bergen, Norway.; Haraldsplass Deaconess Hospital, Bergen, Norway., Blomberg B; Department of Clinical Science, University of Bergen, Bergen, Norway.; Norwegian National Advisory Unit on Tropical Infectious Diseases, Haukeland University Hospital, Bergen, Norway., Buanes EA; Norwegian Intensive Care and Pandemic Registry (NIPaR), Haukeland University Hospital, Bergen, Norway.; Helse Bergen Health Trust, Haukeland University Hospital, Bergen, Norway., Langeland N; Department of Clinical Science, University of Bergen, Bergen, Norway.; Norwegian National Advisory Unit on Tropical Infectious Diseases, Haukeland University Hospital, Bergen, Norway., Mohn KG; Influenza Centre, Department of Clinical Science, University of Bergen, Bergen, Norway.; Department of Medicine, Haukeland University Hospital, Bergen, Norway.
Jazyk: angličtina
Zdroj: Infectious diseases (London, England) [Infect Dis (Lond)] 2022 Feb; Vol. 54 (2), pp. 79-89. Date of Electronic Publication: 2021 Sep 16.
DOI: 10.1080/23744235.2021.1974539
Abstrakt: Background: COVID-19 patients are extensively treated with antibiotics despite few bacterial complications. We aimed to study antibiotic use in hospitalized COVID-19 patients compared to influenza patients in two consecutive years. Furthermore, we investigated changes in antibiotic use from the first to second pandemic wave.
Methods: This prospective study included both patients from two referral hospitals in Bergen, Norway, admitted with influenza ( n  = 215) during the 2018/2019 epidemic and with COVID-19 ( n  = 82) during spring/summer 2020, and national data on registered Norwegian COVID-19 hospital admissions from March 2020 to January 2021 ( n  = 2300). Patient characteristics were compared, and logistic regression analysis was used to identify risk factors for antibiotic use.
Results: National and local COVID-19 patients received significantly less antibiotics (53% and 49%) than influenza patients (69%, p  < .001). Early antibiotics contributed to >90% of antibiotic prescriptions in the two local hospitals, and >70% of prescriptions nationally. When adjusted for age, comorbidities, symptom duration, chest X-ray infiltrates and oxygen treatment, local COVID-19 patients still had significantly lower odds of antibiotic prescription than influenza patients (aOR 0.21, 95%CI 0.09-0.50). At the national level, we observed a significant reduction in antibiotic prescription rates in the second pandemic wave compared to the first (aOR 0.35, 95% CI 0.29-0.43).
Conclusion: Fewer COVID-19 patients received antibiotics compared to influenza patients admitted to the two local hospitals one year earlier. The antibiotic prescription rate was lower during the second pandemic wave, possibly due to increased clinical experience and published evidence refuting the efficacy of antibiotics in treating COVID-19 pneumonia.
Databáze: MEDLINE
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