J Korean Med Sci.  2022 Jul;37(29):e238. 10.3346/jkms.2022.37.e238.

Clinical Impact of Empirical Antibiotic Therapy in Patients With Coronavirus Disease 2019 Requiring Oxygen Therapy

Affiliations
  • 1Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea

Abstract

Despite the low prevalence of secondary bacterial infection in coronavirus disease 2019 (COVID-19) patients, most of them were administered antibiotic therapy empirically. However, the prognostic impact of empirical antibiotic therapy has not been evaluated. We conducted retrospective propensity score-matched case-control study of 233 COVID-19 patients with moderate to severe illnesses who required oxygen therapy and evaluated whether empirical antibiotic therapy could improve clinical outcomes. Empirical antibiotic therapy did not improve clinical outcomes including length of stay, days with oxygen requirement, the proportion of patients with increased oxygen demand, the proportion of patients who required mechanical ventilation, and overall mortality. This finding implies that routine administration of antibiotics for the treatment of COVID-19 is not essential and should be restricted.

Keyword

Coronavirus Disease 2019; Antibiotics; Antimicrobial Stewardship

Cited by  1 articles

To Prescribe, or Not to Prescribe, That Is the Question
Chin Kook Rhee
J Korean Med Sci. 2022;37(29):e240.    doi: 10.3346/jkms.2022.37.e240.


Reference

1. Gautret P, Lagier JC, Parola P, Hoang VT, Meddeb L, Mailhe M, et al. Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial. Int J Antimicrob Agents. 2020; 56(1):105949. PMID: 32205204.
Article
2. Yacouba A, Olowo-Okere A, Yunusa I. Repurposing of antibiotics for clinical management of COVID-19: a narrative review. Ann Clin Microbiol Antimicrob. 2021; 20(1):37. PMID: 34020659.
Article
3. Oldenburg CE, Pinsky BA, Brogdon J, Chen C, Ruder K, Zhong L, et al. Effect of oral azithromycin vs placebo on COVID-19 symptoms in outpatients with SARS-CoV-2 infection: a randomized clinical trial. JAMA. 2021; 326(6):490–498. PMID: 34269813.
Article
4. Scroggs SL, Offerdahl DK, Flather DP, Morris CN, Kendall BL, Broeckel RM, et al. Fluoroquinolone antibiotics exhibit low antiviral activity against SARS-CoV-2 and MERS-CoV. Viruses. 2020; 13(1):8.
Article
5. National Institutes of Health, COVID-19 Treatment Guidelines Panel. Coronavirus disease 2019 (COVID-19) treatment guidelines. Updated 2022. Accessed March 1, 2022. https://www.covid19treatmentguidelines.nih.gov/ .
6. Bartoletti M, Azap O, Barac A, Bussini L, Ergonul O, Krause R, et al. ESCMID COVID-19 living guidelines: drug treatment and clinical management. Clin Microbiol Infect. 2022; 28(2):222–238. PMID: 34823008.
Article
7. Shin DH, Kang M, Song KH, Jung J, Kim ES, Kim HB. A call for antimicrobial stewardship in patients with COVID-19: a nationwide cohort study in Korea. Clin Microbiol Infect. 2021; 27(4):653–655. PMID: 33137513.
Article
8. National Institutes of Health. Clinical spectrum of SARS-CoV-2 infection. Updated 2021. Accessed August 2021. https://www.covid19treatmentguidelines.nih.gov/overview/clinical-spectrum/ .
9. Tamma PD, Avdic E, Li DX, Dzintars K, Cosgrove SE. Association of adverse events with antibiotics use in hospitalized patients. JAMA Intern Med. 2017; 177(9):1308–1315. PMID: 28604925.
Article
10. Lansbury L, Lim B, Baskaran V, Lim WS. Co-infections in people with COVID-19: a systematic review and meta-analysis. J Infect. 2020; 81(2):266–275. PMID: 32473235.
Article
11. Langford BJ, So M, Raybardhan S, Leung V, Westwood D, MacFadden DR, et al. Bacterial co-infection and secondary infection in patients with COVID-19: a living rapid review and meta-analysis. Clin Microbiol Infect. 2020; 26(12):1622–1629. PMID: 32711058.
Article
12. Al-Hadidi SH, Alhussain H, Abdel Hadi H, Johar A, Yassine HM, Al Thani AA, et al. The spectrum of antibiotic prescribing during COVID-19 pandemic: a systematic literature review. Microb Drug Resist. 2021; 27(12):1705–1725. PMID: 34077290.
Article
13. Sieswerda E, de Boer MG, Bonten MM, Boersma WG, Jonkers RE, Aleva RM, et al. Recommendations for antibacterial therapy in adults with COVID-19 - an evidence based guideline. Clin Microbiol Infect. 2021; 27(1):61–66. PMID: 33010444.
Article
Full Text Links
  • JKMS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr