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Early empiric antibiotic use in COVID-19 patients: results from the international VIRUS registry.
Sili, Uluhan; Tekin, Aysun; Bilgin, Huseyin; Khan, Syed Anjum; Domecq, Juan Pablo; Vadgaonkar, Girish; Segu, Smitha S; Rijhwani, Puneet; Raju, Umamaheswara; Surapaneni, Krishna Mohan; Zabolotskikh, Igor; Gomaa, Dina; Goodspeed, Valerie M; Ay, Pinar.
Affiliation
  • Sili U; Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Marmara University, Istanbul, Türkiye. Electronic address: uluhan@hotmail.com.
  • Tekin A; Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, United States.
  • Bilgin H; Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Marmara University, Istanbul, Türkiye.
  • Khan SA; Division of Critical Care Medicine, Mayo Clinic Health System, Mankato, Minnesota, United States.
  • Domecq JP; Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, United States.
  • Vadgaonkar G; BSES MG Hospital, Mumbai, India.
  • Segu SS; Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India.
  • Rijhwani P; Department of Medicine, Mahatma Gandhi University of Medical Sciences & Technology, Jaipur, Rajasthan, India.
  • Raju U; Gandhi Medical College and Hospital, Hyderabad, India.
  • Surapaneni KM; Departments of Biochemistry, Molecular Virology, Research and Clinical Skills & Simulation, Panimalar Medical College Hospital & Research Institute, Varadharajapuram, Poonamallee, Chennai, Tamil Nadu, India.
  • Zabolotskikh I; Department of Anesthesiology, Intensive Care Medicine and Transfusiology, Kuban State Medical University with affiliation Territorial Hospital #2, Krasnodar, Russia.
  • Gomaa D; Department of Surgery Division of Trauma and Critical Care- Trauma Research University of Cincinnati, Cincinnati, Ohio, United States.
  • Goodspeed VM; Department of Anesthesiology, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States.
  • Ay P; Department of Public Health, School of Medicine, Marmara University, Istanbul, Türkiye.
Int J Infect Dis ; 140: 39-48, 2024 Mar.
Article in En | MEDLINE | ID: mdl-38128643
ABSTRACT

OBJECTIVES:

COVID-19 escalated inappropriate antibiotic use. We determined the distribution of pathogens causing community-acquired co-infections, the rate, and factors associated with early empiric antibiotic (EEAB) treatment among hospitalized COVID-19 patients.

METHODS:

The Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS) COVID-19 Registry including 68,428 patients from 28 countries enrolled between January 2020 and October 2021 were screened. After exclusions, 7830 patients were included in the analysis. Azithromycin and/or other antibiotic treatment given within the first 3 days of hospitalization was investigated. Univariate and multivariate analyses were performed to determine factors associated with EEAB use.

RESULTS:

The majority (6214, 79.4%) of patients received EEAB, with azithromycin combination being the most frequent (3146, 40.2%). As the pandemic advanced, the proportion of patients receiving EEAB regressed from 84.4% (786/931) in January-March 2020 to 65.2% (30/46) in April-June 2021 (P < 0.001). Beta-lactams, especially ceftriaxone was the most commonly used antibiotic. Staphylococcus aureus was the most commonly isolated pathogen. Multivariate analysis showed geographical location and pandemic timeline as the strongest independent predictors of EEAB use.

CONCLUSIONS:

EEAB administration decreased as pandemic advanced, which may be the result of intensified antimicrobial stewardship efforts. Our study provides worldwide goals for antimicrobial stewardship programs in the post-COVID-19 era.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Community-Acquired Infections / COVID-19 Limits: Humans Language: En Journal: Int J Infect Dis Journal subject: DOENCAS TRANSMISSIVEIS Year: 2024 Document type: Article

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Community-Acquired Infections / COVID-19 Limits: Humans Language: En Journal: Int J Infect Dis Journal subject: DOENCAS TRANSMISSIVEIS Year: 2024 Document type: Article