Early administered antibiotics do not impact mortality in critically ill patients with COVID-19.

Buetti, Niccolò; Mazzuchelli, Timothy; Priore, Elia Lo; Balmelli, Carlo; Llamas, Michael; Pallanza, Micol; Elzi, Luigia; Consonni, Vera; Trimboli, Pierpaolo; Forni-Ogna, Valentina; Bernasconi, Enos

doi:10.1016/j.jinf.2020.06.004

Cited by 64 publications

(62 citation statements)

References 4 publications

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“…Of 16,378 studies identified, after duplicate removal, we reviewed a total of 7469 studies via title and abstract screening, 523 of which were assessed via full-text screening. We included 154 studies in the final analysis ( 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 ,…”

Section: Resultsmentioning

confidence: 99%

Antibiotic prescribing in patients with COVID-19: rapid review and meta-analysis

Langford

Raybardhan

et al. 2021

Clinical Microbiology and Infection

655

519

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Section: Resultsmentioning

confidence: 99%

Antibiotic prescribing in patients with COVID-19: rapid review and meta-analysis

Langford

Raybardhan

et al. 2021

Clinical Microbiology and Infection

655

519

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“…COVID-19 is known to cause a sepsis syndrome [ 4 , 21–23 ]; in our cohort, 25% of patients adjudicated to not have bCAP met sepsis criteria, highlighting the complexity around antibiotic decision-making in patients with COVID-19. A previous study of COVID-19 patients admitted to the ICU failed to demonstrate a benefit of early antibiotics (ie, antibiotics given before arrival to the ICU) on mortality or development of ventilator-associated infection or bacteremia [ 24 ]. This underscores the ongoing need for more accurate ways to identify patients likely to benefit from antibiotics in lower respiratory tract infections.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Co-infection at the Time of Hospital Admission in COVID-19 Patients, A Multicenter Study

Karaba

Jones

Helsel

et al. 2020

Open Forum Infectious Diseases

107

100

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Background Bacterial infections may complicate viral pneumonias. Recent reports suggest that bacterial co-infection at time of presentation is uncommon in coronavirus disease 2019 (COVID-19); however, estimates were based on microbiology tests alone. We sought to develop and apply consensus definitions, incorporating clinical criteria to better understand the rate of co-infections and antibiotic use in COVID-19. Methods A total of 1016 adult patients admitted to 5 hospitals in the Johns Hopkins Health System between March 1, 2020, and May 31, 2020, with COVID-19 were evaluated. Adjudication of co-infection using definitions developed by a multidisciplinary team for this study was performed. Both respiratory and common nonrespiratory co-infections were assessed. The definition of bacterial community-acquired pneumonia (bCAP) included proven (clinical, laboratory, and radiographic criteria plus microbiologic diagnosis), probable (clinical, laboratory, and radiographic criteria without microbiologic diagnosis), and possible (not all clinical, laboratory, and radiographic criteria met) categories. Clinical characteristics and antimicrobial use were assessed in the context of the consensus definitions. Results Bacterial respiratory co-infections were infrequent (1.2%); 1 patient had proven bCAP, and 11 (1.1%) had probable bCAP. Two patients (0.2%) had viral respiratory co-infections. Although 69% of patients received antibiotics for pneumonia, the majority were stopped within 48 hours in patients with possible or no evidence of bCAP. The most common nonrespiratory infection was urinary tract infection (present in 3% of the cohort). Conclusions Using multidisciplinary consensus definitions, proven or probable bCAP was uncommon in adults hospitalized due to COVID-19, as were other nonrespiratory bacterial infections. Empiric antibiotic use was high, highlighting the need to enhance antibiotic stewardship in the treatment of viral pneumonias.

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“…18 Additionally, early guidelines for critically ill patients with COVID-19 recommended consideration of antibiotics due to the possibility of bacterial co-infection, despite a lack of evidence demonstrating improved outcomes. 19,20 Although not directly related to COVID-19 infections, the pandemic public health response effort appears to have significantly altered patterns of ED utilization. Several reports confirm dramatic decreases in ED volumes for emergent conditions, potentially related to "stay at home" orders or fear of COVID-19 exposure in the hospital.…”

Section: Potential Adverse Effects Of Covid-19 On Emergency Departmenmentioning

confidence: 99%

Section: Potential Adverse Effects Of Covid-19 On Emergency Departmenmentioning

confidence: 99%

COVID-19: An Emerging Threat to Antibiotic Stewardship in the Emergency Department

Pulia

Wolf

Schulz

et al. 2020

WestJEM

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Due to the rapidly evolving nature of this outbreak, and in the interests of rapid dissemination of reliable, actionable information, this paper went through expedited peer review. Additionally, information should be considered current only at the time of publication and may evolve as the science develops. BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel viral pathogen and its associated clinical syndrome (COVID-19) is the cause of an ongoing global pandemic involving hundreds of thousands of deaths. While current research efforts focus primarily on identifying therapeutic interventions, it is important to consider the collateral effects of COVID-19 on other public health crises.

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Early administered antibiotics do not impact mortality in critically ill patients with COVID-19.

Abstract: Early administered antibiotics do not impact mortality in critically ill patients with COVID-19.

Cited by 64 publications

References 4 publications

Antibiotic prescribing in patients with COVID-19: rapid review and meta-analysis

Antibiotic prescribing in patients with COVID-19: rapid review and meta-analysis

Prevalence of Co-infection at the Time of Hospital Admission in COVID-19 Patients, A Multicenter Study

COVID-19: An Emerging Threat to Antibiotic Stewardship in the Emergency Department

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