Initial Empirical Antibiotic Treatment in Covid-19 Patients is Related with Excess Adverse Drug Reactions Without Clinical Benefit
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Original Article
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Initial Empirical Antibiotic Treatment in Covid-19 Patients is Related with Excess Adverse Drug Reactions Without Clinical Benefit

Turk J Pharm Sci 0;0(0):0-0
1. Hacettepe University Faculty of Pharmacy, Department of Clinical Pharmacy, Ankara, Türkiye
2. Hacettepe University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Ankara, Türkiye
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ABSTRACT

Objectives:

Empirical antibiotic use is common in hospitalized patients with COVID-19 pneumonia because it is difficult to differentiate it from concurrent bacterial pneumonia. In this study, we investigated risk factors for concurrent bacterial community-acquired pneumonia (b-CAP) and the need for initial empirical antibiotic coverage when patients presented with pulmonary involvement caused by SARS CoV-2.

Materials and Methods:

This study was conducted as a prospective observational study in a tertiary university hospital between March 2020 and April 2021. Patients over 18 years of age who were hospitalized with COVID-19 pneumonia were included. Risk factors and outcomes were compared between the patients who received initial empirical antibiotics and those who did not.

Results:

The presence of respiratory viral pathogens other than SARS CoV-2 was investigated via a respiratory panel multiplex polymerase chain reaction in 295 patients, and potential bacterial respiratory pathogens in 306 patients on admission to the hospital. Although the co-infection rate was low (17.4%), half of the patients (205/409, 50.1%) were administered initial empirical antibiotics for suspected concurrent b-CAP. Antibiotic use was higher in patients with multiple comorbidities, severe to critical pneumonia, and patients over 65 years (p<0.001). The overall 30-day mortality was significantly higher (26.3% and 2.0%, p<0.001), and the duration of hospital stay was longer (median 13.0 and 5.5 days, p<0.001) in patients who received empirical antibacterial agents.

Conclusions:

Initial empirical antibiotic treatment is common in patients infected with SARS CoV-2, although the co-infection rate is low. Empirical antibiotic(s) did not improve the clinical course in COVID-19 patients.

Keywords: COVID-19, antimicrobial, empirical therapy, co-infections, community-acquired pneumonia

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