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.
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. |
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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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