Antibiotic use in patients with COVID-19: a 'snapshot' Infectious Diseases International Research Initiative (ID-IRI) survey. (7th August 2020)

• Record Type: Journal Article
• Authors: Beović, Bojana; Doušak, May; Ferreira-Coimbra, João; Nadrah, Kristina; Rubulotta, Francesca; Belliato, Mirko; Berger-Estilita, Joana; Ayoade, Folusakin; Rello, Jordi; Erdem, Hakan
• Is Part Of: Journal of antimicrobial chemotherapy. Volume 75:Number 11(2020)
• Page Start: 3386
• Page End: 3390
• Publication Date: 2020-08-07
• Subjects: Anti-infective agents -- Periodicals; Chemotherapy -- Periodicals; 615.58
• DOI: 10.1093/jac/dkaa326
• Languages: English
• ISSNs: 0305-7453

Abstract

Abstract: Background: Antibiotics may be indicated in patients with COVID-19 due to suspected or confirmed bacterial superinfection. Objectives: To investigate antibiotic prescribing practices in patients with COVID-19. Methods: We performed an international web-based survey and investigated the pattern of antibiotic use as reported by physicians involved in treatment of COVID-19. SPSS Statistics version 25 was used for data analysis. Results: The survey was completed by 166 participants from 23 countries and 82 different hospitals. Local guidelines for antibiotic use in COVID-19 patients were reported by 61.8% ( n = 102) of participants and for 82.9% ( n = 136) they did not differ from local community-acquired pneumonia guidelines. Clinical presentation was recognized as the most important reason for the start of antibiotics (mean score = 4.07 and SD = 1.095 on grading scale from 1 to 5). When antibiotics were started, most respondents rated as the highest the need for coverage of atypical pathogens (mean score = 2.8 and SD = 0.99), followed by Staphylococcus aureus (mean score = 2.67 and SD = 1.05 on bi-modal scale, with values 1 and 2 for disagreement and values 3 and 4 for agreement). In the patients on the ward, 29.1% of respondents chose not to prescribe any antibiotic. Combination of β-lactams and macrolides or fluoroquinolones was reported by 52.4% ( n = 87) of respondents. In patients in the ICU, piperacillin/tazobactam was the most commonly prescribed antibiotic. The mean reported duration of antibiotic treatment was 7.12 (SD = 2.44) days. Conclusions: The study revealed widespread broad-spectrum antibiotic use in patients with COVID-19. Implementation of antimicrobial stewardship principles is warranted to mitigate the negative consequences of antibiotic therapy.