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  1. Article ; Online: Few bacterial co-infections but frequent empiric antibiotic use in the early phase of hospitalized patients with COVID-19: results from a multicentre retrospective cohort study in The Netherlands.

    Karami, Zara / Knoop, Bram T / Dofferhoff, Anton S M / Blaauw, Marc J T / Janssen, Nico A / van Apeldoorn, Marjan / Kerckhoffs, Angèle P M / van de Maat, Josephine S / Hoogerwerf, Jacobien J / Ten Oever, Jaap

    Infectious diseases (London, England)

    2020  Volume 53, Issue 2, Page(s) 102–110

    Abstract: Background: Knowledge on bacterial co-infections in COVID-19 is crucial to use antibiotics appropriately. Therefore, we aimed to determine the incidence of bacterial co-infections, antibiotic use and application of antimicrobial stewardship principles ... ...

    Abstract Background: Knowledge on bacterial co-infections in COVID-19 is crucial to use antibiotics appropriately. Therefore, we aimed to determine the incidence of bacterial co-infections, antibiotic use and application of antimicrobial stewardship principles in hospitalized patients with COVID-19.
    Methods: We performed a retrospective observational study in four hospitals (1 university, 2 non-university teaching, 1 non-teaching hospital) in the Netherlands from March to May 2020 including consecutive patients with PCR-confirmed COVID-19. Data on first microbiological investigations obtained at the discretion of the physician and antibiotic use in the first week of hospital admission were collected.
    Results: Twelve (1.2%) of the 925 patients included had a documented bacterial co-infection (75.0% pneumonia) within the first week. Microbiological testing was performed in 749 (81%) patients: sputum cultures in 105 (11.4%), blood cultures in 711 (76.9%), pneumococcal urinary antigen testing in 202 (21.8%), and
    Conclusions: On presentation to the hospital bacterial co-infections are rare, while empiric antibiotic use is abundant. This implies that in patients with COVID-19 empiric antibiotic should be withheld. This has the potential to dramatically reduce the current overuse of antibiotics in the COVID-19 pandemic.
    MeSH term(s) Aged ; Anti-Bacterial Agents/administration & dosage ; Antimicrobial Stewardship ; Bacterial Infections/drug therapy ; Bacterial Infections/epidemiology ; Bacterial Infections/microbiology ; Blood Culture ; COVID-19/epidemiology ; COVID-19/virology ; Coinfection ; Drug Administration Routes ; Drug Administration Schedule ; Female ; Guideline Adherence/statistics & numerical data ; Hospitalization ; Humans ; Incidence ; Male ; Middle Aged ; Netherlands/epidemiology ; Pandemics ; Prescription Drug Overuse/prevention & control ; Prescription Drug Overuse/statistics & numerical data ; Retrospective Studies ; SARS-CoV-2/pathogenicity
    Chemical Substances Anti-Bacterial Agents
    Keywords covid19
    Language English
    Publishing date 2020-10-24
    Publishing country England
    Document type Journal Article ; Multicenter Study ; Observational Study
    ZDB-ID 2839775-7
    ISSN 2374-4243 ; 2374-4235
    ISSN (online) 2374-4243
    ISSN 2374-4235
    DOI 10.1080/23744235.2020.1839672
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Few bacterial co-infections but frequent empiric antibiotic use in the early phase of hospitalized patients with COVID-19

    Karami, Zara / Knoop, Bram T. / Dofferhoff, Anton S. M. / Blaauw, Marc J. T. / Janssen, Nico A. / van Apeldoorn, Marjan / Kerckhoffs, Angèle P. M. / van de Maat, Josephine S. / Hoogerwerf, Jacobien J. / ten Oever, Jaap

    Infectious Diseases

    results from a multicentre retrospective cohort study in The Netherlands

    2020  , Page(s) 1–9

    Keywords Microbiology (medical) ; General Immunology and Microbiology ; Infectious Diseases ; General Medicine ; covid19
    Language English
    Publisher Informa UK Limited
    Publishing country uk
    Document type Article ; Online
    ZDB-ID 2839775-7
    ISSN 2374-4243 ; 2374-4235
    ISSN (online) 2374-4243
    ISSN 2374-4235
    DOI 10.1080/23744235.2020.1839672
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article: Few bacterial co-infections but frequent empiric antibiotic use in the early phase of hospitalized patients with COVID-19: results from a multicentre retrospective cohort study in The Netherlands

    Karami, Zara / Knoop, Bram T / Dofferhoff, Anton S M / Blaauw, Marc J T / Janssen, Nico A / van Apeldoorn, Marjan / Kerckhoffs, Angèle P M / van de Maat, Josephine S / Hoogerwerf, Jacobien J / Ten Oever, Jaap

    Infect Dis (Lond)

    Abstract: BACKGROUND: Knowledge on bacterial co-infections in COVID-19 is crucial to use antibiotics appropriately. Therefore, we aimed to determine the incidence of bacterial co-infections, antibiotic use and application of antimicrobial stewardship principles in ...

    Abstract BACKGROUND: Knowledge on bacterial co-infections in COVID-19 is crucial to use antibiotics appropriately. Therefore, we aimed to determine the incidence of bacterial co-infections, antibiotic use and application of antimicrobial stewardship principles in hospitalized patients with COVID-19. METHODS: We performed a retrospective observational study in four hospitals (1 university, 2 non-university teaching, 1 non-teaching hospital) in the Netherlands from March to May 2020 including consecutive patients with PCR-confirmed COVID-19. Data on first microbiological investigations obtained at the discretion of the physician and antibiotic use in the first week of hospital admission were collected. RESULTS: Twelve (1.2%) of the 925 patients included had a documented bacterial co-infection (75.0% pneumonia) within the first week. Microbiological testing was performed in 749 (81%) patients: sputum cultures in 105 (11.4%), blood cultures in 711 (76.9%), pneumococcal urinary antigen testing in 202 (21.8%), and Legionella urinary antigen testing in 199 (21.5%) patients, with clear variation between hospitals. On presentation 556 (60.1%; range 33.3-73.4%) patients received antibiotics for a median duration of 2 days (IQR 1-4). Intravenous to oral switch was performed in 41 of 413 (9.9%) patients who received intravenous treatment >48 h. Mean adherence to the local guideline on empiric antibiotic therapy on day 1 was on average 60.3% (range 45.3%-74.7%). CONCLUSIONS: On presentation to the hospital bacterial co-infections are rare, while empiric antibiotic use is abundant. This implies that in patients with COVID-19 empiric antibiotic should be withheld. This has the potential to dramatically reduce the current overuse of antibiotics in the COVID-19 pandemic.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #889455
    Database COVID19

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