Antibiotic Prescription and In-Hospital Mortality in COVID-19: A Prospective Multicentre Cohort Study

Background: Since the beginning of the COVID-19 pandemic, empiric antibiotics (ATBs) have been prescribed on a large scale in both in- and outpatients. We aimed to assess the impact of antibiotic treatment on the outcomes of hospitalised patients with moderate and severe coronavirus disease 2019 (CO...

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Published in:Journal of personalized medicine 2022-05, Vol.12 (6), p.877
Main Authors: Pinte, Larisa, Ceasovschih, Alexandr, Niculae, Cristian-Mihail, Stoichitoiu, Laura Elena, Ionescu, Razvan Adrian, Balea, Marius Ioan, Cernat, Roxana Carmen, Vlad, Nicoleta, Padureanu, Vlad, Purcarea, Adrian, Badea, Camelia, Hristea, Adriana, Sorodoc, Laurenţiu, Baicus, Cristian
Format: Article
Language:English
Subjects:
Antibiotics
Bacterial infections
Cohort analysis
Coronaviruses
COVID-19
Death
Mortality
Patients
Precision medicine
Statistical analysis
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Summary:Background: Since the beginning of the COVID-19 pandemic, empiric antibiotics (ATBs) have been prescribed on a large scale in both in- and outpatients. We aimed to assess the impact of antibiotic treatment on the outcomes of hospitalised patients with moderate and severe coronavirus disease 2019 (COVID-19). Methods: We conducted a prospective multicentre cohort study in six clinical hospitals, between January 2021 and May 2021. Results: We included 553 hospitalised COVID-19 patients, of whom 58% (311/553) were prescribed antibiotics, while bacteriological tests were performed in 57% (178/311) of them. Death was the outcome in 48 patients—39 from the ATBs group and 9 from the non-ATBs group. The patients who received antibiotics during hospitalisation had a higher mortality (RR = 3.37, CI 95%: 1.7–6.8), and this association was stronger in the subgroup of patients without reasons for antimicrobial treatment (RR = 6.1, CI 95%: 1.9–19.1), while in the subgroup with reasons for antimicrobial therapy the association was not statistically significant (OR = 2.33, CI 95%: 0.76–7.17). After adjusting for the confounders, receiving antibiotics remained associated with a higher mortality only in the subgroup of patients without criteria for antibiotic prescription (OR = 10.3, CI 95%: 2–52). Conclusions: In our study, antibiotic treatment did not decrease the risk of death in the patients with mild and severe COVID-19, but was associated with a higher risk of death in the subgroup of patients without reasons for it.
ISSN:2075-4426
2075-4426
DOI:10.3390/jpm12060877