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

Identifieur interne : 001698 ( Main/Exploration ); précédent : 001697; suivant : 001699

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

Auteurs : Bojana Beovi [Slovénie] ; May Doušak [Slovénie] ; João Ferreira-Coimbra [Portugal] ; Kristina Nadrah [Slovénie] ; Francesca Rubulotta [Royaume-Uni] ; Mirko Belliato [Italie] ; Joana Berger-Estilita [Suisse] ; Folusakin Ayoade [États-Unis] ; Jordi Rello [France, Espagne] ; Hakan Erdem [Turquie]

Source :

RBID : pubmed:32766706

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.


DOI: 10.1093/jac/dkaa326
PubMed: 32766706
PubMed Central: PMC7454563


Affiliations:


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<region type="old region">Languedoc-Roussillon</region>
<settlement type="city">Nîmes</settlement>
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<name sortKey="Erdem, Hakan" sort="Erdem, Hakan" uniqKey="Erdem H" first="Hakan" last="Erdem">Hakan Erdem</name>
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<title level="j">The Journal of antimicrobial chemotherapy</title>
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<b>BACKGROUND</b>
</p>
<p>Antibiotics may be indicated in patients with COVID-19 due to suspected or confirmed bacterial superinfection.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>OBJECTIVES</b>
</p>
<p>To investigate antibiotic prescribing practices in patients with COVID-19.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>METHODS</b>
</p>
<p>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.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>RESULTS</b>
</p>
<p>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.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>CONCLUSIONS</b>
</p>
<p>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.</p>
</div>
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<Month>Aug</Month>
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<Title>The Journal of antimicrobial chemotherapy</Title>
<ISOAbbreviation>J. Antimicrob. Chemother.</ISOAbbreviation>
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<AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Antibiotics may be indicated in patients with COVID-19 due to suspected or confirmed bacterial superinfection.</AbstractText>
<AbstractText Label="OBJECTIVES" NlmCategory="OBJECTIVE">To investigate antibiotic prescribing practices in patients with COVID-19.</AbstractText>
<AbstractText Label="METHODS" NlmCategory="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.</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="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.</AbstractText>
<AbstractText Label="CONCLUSIONS" NlmCategory="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.</AbstractText>
<CopyrightInformation>© The Author(s) 2020. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please email: journals.permissions@oup.com.</CopyrightInformation>
</Abstract>
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<LastName>Beović</LastName>
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<Initials>B</Initials>
<AffiliationInfo>
<Affiliation>University Medical Centre Ljubljana, Ljubljana, Slovenia.</Affiliation>
</AffiliationInfo>
<AffiliationInfo>
<Affiliation>Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.</Affiliation>
</AffiliationInfo>
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<LastName>Nadrah</LastName>
<ForeName>Kristina</ForeName>
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<Initials>H</Initials>
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<Affiliation>ID-IRI, Ankara, Turkey.</Affiliation>
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<Country>England</Country>
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<Hour>6</Hour>
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<Reference>
<Citation>Clin Infect Dis. 2020 Jul 28;71(15):706-712</Citation>
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<ArticleId IdType="pubmed">32109279</ArticleId>
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</Reference>
<Reference>
<Citation>N Engl J Med. 2020 Apr 30;382(18):1708-1720</Citation>
<ArticleIdList>
<ArticleId IdType="pubmed">32109013</ArticleId>
</ArticleIdList>
</Reference>
<Reference>
<Citation>Lancet. 2020 Mar 28;395(10229):1054-1062</Citation>
<ArticleIdList>
<ArticleId IdType="pubmed">32171076</ArticleId>
</ArticleIdList>
</Reference>
<Reference>
<Citation>Clin Microbiol Infect. 2020 Jul;26(7):808-810</Citation>
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<ArticleId IdType="pubmed">32360446</ArticleId>
</ArticleIdList>
</Reference>
<Reference>
<Citation>Clin Chim Acta. 2020 Jun;505:190-191</Citation>
<ArticleIdList>
<ArticleId IdType="pubmed">32145275</ArticleId>
</ArticleIdList>
</Reference>
<Reference>
<Citation>Lancet. 2020 Feb 15;395(10223):507-513</Citation>
<ArticleIdList>
<ArticleId IdType="pubmed">32007143</ArticleId>
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</Reference>
<Reference>
<Citation>Crit Care. 2019 Jul 19;23(1):258</Citation>
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<ArticleId IdType="pubmed">31324202</ArticleId>
</ArticleIdList>
</Reference>
<Reference>
<Citation>JAMA. 2020 Apr 15;:</Citation>
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<li>France</li>
<li>Italie</li>
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<li>Royaume-Uni</li>
<li>Slovénie</li>
<li>Suisse</li>
<li>Turquie</li>
<li>États-Unis</li>
</country>
<region>
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<li>Canton de Berne</li>
<li>Catalogne</li>
<li>Communauté de Madrid</li>
<li>Floride</li>
<li>Grand Londres</li>
<li>Languedoc-Roussillon</li>
<li>Occitanie (région administrative)</li>
</region>
<settlement>
<li>Barcelone</li>
<li>Berne</li>
<li>Londres</li>
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<name sortKey="Nadrah, Kristina" sort="Nadrah, Kristina" uniqKey="Nadrah K" first="Kristina" last="Nadrah">Kristina Nadrah</name>
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<name sortKey="Ferreira Coimbra, Joao" sort="Ferreira Coimbra, Joao" uniqKey="Ferreira Coimbra J" first="João" last="Ferreira-Coimbra">João Ferreira-Coimbra</name>
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</country>
<country name="Royaume-Uni">
<region name="Angleterre">
<name sortKey="Rubulotta, Francesca" sort="Rubulotta, Francesca" uniqKey="Rubulotta F" first="Francesca" last="Rubulotta">Francesca Rubulotta</name>
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</country>
<country name="Italie">
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<name sortKey="Belliato, Mirko" sort="Belliato, Mirko" uniqKey="Belliato M" first="Mirko" last="Belliato">Mirko Belliato</name>
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<country name="Suisse">
<region name="Canton de Berne">
<name sortKey="Berger Estilita, Joana" sort="Berger Estilita, Joana" uniqKey="Berger Estilita J" first="Joana" last="Berger-Estilita">Joana Berger-Estilita</name>
</region>
</country>
<country name="États-Unis">
<region name="Floride">
<name sortKey="Ayoade, Folusakin" sort="Ayoade, Folusakin" uniqKey="Ayoade F" first="Folusakin" last="Ayoade">Folusakin Ayoade</name>
</region>
</country>
<country name="France">
<region name="Occitanie (région administrative)">
<name sortKey="Rello, Jordi" sort="Rello, Jordi" uniqKey="Rello J" first="Jordi" last="Rello">Jordi Rello</name>
</region>
</country>
<country name="Espagne">
<region name="Catalogne">
<name sortKey="Rello, Jordi" sort="Rello, Jordi" uniqKey="Rello J" first="Jordi" last="Rello">Jordi Rello</name>
</region>
<name sortKey="Rello, Jordi" sort="Rello, Jordi" uniqKey="Rello J" first="Jordi" last="Rello">Jordi Rello</name>
</country>
<country name="Turquie">
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<name sortKey="Erdem, Hakan" sort="Erdem, Hakan" uniqKey="Erdem H" first="Hakan" last="Erdem">Hakan Erdem</name>
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</record>

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