Antibiotic prescribing patterns in patients hospitalized with COVID-19: lessons from the first wave
| Autor: | Peter Doran, Louise Vidal, Gordana Avramovic, Eavan G Muldoon, Brendan O'Kelly, Jonathan McGrath, Stephen Peter Connolly, Tina McHugh, Gerard Sheehan, Walter Cullen, Sean Griffin, Colm Cronin, David Connellan, Aoife G. Cotter, John S. Lambert, Tara McGinty |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty Coronavirus disease 2019 (COVID-19) medicine.drug_class business.industry 030106 microbiology Antibiotics Retrospective cohort study medicine.disease Neutrophilia Antibiotic prescribing 03 medical and health sciences Pneumonia 0302 clinical medicine AcademicSubjects/MED00290 Internal medicine medicine Coinfection AcademicSubjects/MED00740 Original Article 030212 general & internal medicine medicine.symptom Medical prescription business AcademicSubjects/MED00230 |
| Zdroj: | JAC-Antimicrobial Resistance |
| ISSN: | 2632-1823 |
| Popis: | Background A high proportion of hospitalized patients with COVID-19 receive antibiotics despite evidence to show low levels of true bacterial coinfection. Methods A retrospective cohort study examining antibiotic prescribing patterns of 300 patients sequentially diagnosed with COVID-19. Patients were grouped into 3 sub-cohorts: Group 1 received no antibiotics, Group 2 received antibiotics for microbiologically confirmed infections and Group 3 was empirically treated with antibiotics for pneumonia. The primary aim was to identify factors that influenced prescription and continuation of antibiotics in Group 3. Secondary aims were to examine differences in outcomes between groups. Results In total, 292 patients were included (63 Group 1, 35 Group 2, 194 Group 3), median age was 60 years (IQR 44–76) and the majority were ethnically Irish (62%). The median duration of antibiotics was 7 days (IQR 5–10). In Group 3, factors associated with prescription IV antibiotics on admission were raised C-reactive protein (CRP) (P = 0.024), increased age (P = 0.023), higher quick SOFA (P = 0.016) score and fever >37.5 °C (P = 0.011). Factors associated with duration of antibiotic course were duration of hypoxia (P Conclusions Duration of hypoxia and need for respiratory support may have acted as surrogate measures of improvement where usual response measures (CRP, neutrophilia, culture clearance) were absent. Continuous review of antibiotic prescriptions should be at the forefront of clinical management of hospitalized patients with COVID-19. |
| Databáze: | OpenAIRE |
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