Antibiotic Use and Bacterial Infection in COVID-19 Patients in the Second Phase of the SARS-CoV-2 Pandemic: A Scoping Review

Abstract

This scoping review aimed to explore the prevalence and patterns of global antibiotic use and bacterial infection in COVID-19 patients from studies published between June 2020 and March 2021. This review was reported in line with the Preferred Reporting of Systematic Reviews and Meta-Analyses (PRISMA) extension for Scoping Reviews, and the protocol is registered with the Open Science Framework. Compared with our previously-published review of the period (December 2019–June 2020), the antibiotic prescribing rate for COVID-19 patients (June 2020–March 2021) was found to have declined overall (82.3% vs. 39.7%), for mild and moderate patients (75.1% vs. 15.5%), and for severe and critical patients (75.3% vs. 48.3%). The seven most frequently prescribed antibiotics in COVID-19 patients were all on the “Watch” list of the WHO AWaRe antibiotics classification. The overall reported bacterial infection rate in COVID-19 patients was 10.5%, and the most frequently reported resistant pathogen in COVID-19 patients was Staphylococcus aureus, followed by Pseudomonas aeruginosa, Escherichia coli, and Klebsiella pneumoniae. There is an urgent need to establish comprehensive and consistent guidelines to assist clinicians in selecting appropriate antibiotics for COVID-19 patients when needed. The resistance data on the most frequently used antibiotics for COVID-19 patients for certain resistant pathogens should be closely monitored.

Association of biomarkers with successful ventilatory weaning in COVID-19 patients: an observational study

“…This review points to a large dissociation between evidence of bacterial infection and the use of antimicrobials, as only 16% of studies reported indications of bacterial infection, while 54% of patients received empirical antibiotic therapy. ( 37 ) Furthermore, it should be mentioned that critically ill COVID-19 patients admitted to the ICU may have higher rates of secondary bacterial infection, reaching more than 50% of cases. ( 38 )…”

Study of the resistome of human microbial communities using a targeted panel of antibiotic resistance genes in COVID-19 patients

“…Результаты, полученные C. Murray и соавт., указывают на то, что 4,95 млн смертей во всем мире за 2019 г. связаны наличием АБР бактерий к назначаемым АБ [5]. Специалисты Всемирной организации здравоохранения и многочисленные исследователи также подчеркивают, что распространение АБР к противомикробным препаратам является актуальной проблемой, требующей глобального, скоординированного алгоритма действий, направленных на решение складывающейся ситуации [1,[6][7][8][9].…”

“…По данным W. Cong и соавт. установлено, что общий показатель назначения АБ пациентам с COVID-19 снизился с 82,3 до 39,7% в период с декабря 2019 по июнь 2020 г. и с июня 2020 по март 2021 г. соответственно [6].…”

The Assessment of Multiplex PCR in Identifying Bacterial Infections in Patients Hospitalized with SARS-CoV-2 Infection: A Systematic Review

“…This is done in the hope of eliminating any potential bacterial infections that may be present, as the mortality rates are higher in patients who have a co-infection or a superinfection [ 27 , 28 , 29 ]. In spite of the fact that antibiotic use may be helpful, it is important to point out that there is a potential danger of developing antimicrobial resistance when using antibiotics; as a result, the choice of whether or not to receive antibiotic therapy ought to be considered carefully [ 30 , 31 , 32 ].…”