Predictors and patterns of empirical antibiotic therapy and associated outcomes in COVID-19 patients: a retrospective study in a tertiary care facility in South India.

IF 4.2 2区医学 Q1 INFECTIOUS DISEASES

Expert Review of Anti-infective Therapy Pub Date : 2024-05-01 Epub Date: 2024-01-18 DOI:10.1080/14787210.2024.2303019

Lipin Lukose, Gursimran Kaur, Mohammed Asif M, Gail Ann Abraham, Kanav Khera, Viswam K Subeesh, Ronald L Castelino, Shubhada Karanth, Chandrashekar Udyavara Kudru, Muralidhar Varma, Sonal Sekhar Miraj

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引用次数: 0

Abstract

Background: The coronavirus disease (COVID-19) led to a global health crisis. Inappropriate use of antibiotics in COVID-19 patients has been a concern, leading to antimicrobial resistance. This study evaluated the patterns and predictors of empirical antibiotic therapy in COVID-19 patients and associated outcomes.

Methods: A hospital-based retrospective study was conducted with 525 patients admitted to Kasturba Hospital, Manipal, India, with moderate and severe COVID-19 from 1 March to 1 August 2021. They were divided based on empirical therapy, and predictors of antibiotic usage were assessed by logistic regression.

Results: Four hundred and eighty (91.4%) COVID-19 patients received at least one course of antibiotics, with 440 (83.8%) initiating empirical therapy. Patients with severe COVID-19 manifestations were more likely to be prescribed empirical antibiotics. Multivariable analysis showed that patients initiated on empirical antibiotics had significantly elevated levels of procalcitonin [OR: 3.91 (95% CI: 1.66-9.16) (p = 0.001)], invasive ventilation [OR: 3.93 (95% CI: 1.70-9.09) (p = 0.001)], shortness of breath [OR: 2.25 (95% CI: 1.30-3.89) (p = 0.003)] and higher CRP levels [OR: 1.01 (95% CI: 1.00-1.01) (p = 0.005)]. Most antibiotics (65.9%) were prescribed from the 'Watch' group, the highest being ceftriaxone. Only 23.8% of the patients had microbiologically confirmed infections.

Conclusion: The study identified predictors for initiating empirical antibacterial therapy in our setting.

查看原文本刊更多论文

COVID-19 患者经验性抗生素治疗的预测因素和模式及相关结果：印度南部一家三级医疗机构的回顾性研究。

背景：冠状病毒病（COVID-19）导致了全球健康危机，尤其影响到印度等中低收入国家。COVID-19患者抗生素使用不当，导致医疗成本增加、不良事件和抗菌药耐药性，一直是人们关注的问题。本研究评估了 COVID-19 患者经验性抗生素治疗的模式和预测因素以及相关结果：一项基于医院的回顾性观察研究对印度马尼帕尔的卡斯特尔巴医院从 3 月 1 日至 NaN 无效日期收治的 525 名中度和重度 COVID-19 患者进行了研究。根据经验疗法对这些患者进行了分类，并通过逻辑回归评估了与抗生素使用相关的预测因素：480名（91.4%）COVID-19患者接受了至少一个疗程的抗生素治疗，其中440名（83.8%）患者开始接受经验性治疗。有严重COVID-19表现的患者更有可能接受经验性抗生素治疗。多变量分析显示，开始使用经验性抗生素的患者降钙素原水平显著升高[OR：3.91 (95% CI：1.66-9.16) (p = 0.001)]，侵入性通气[OR：3.93 (95%CI: 1.70-9.09) (p = 0.001)]、呼吸急促[OR: 2.25 (95%CI: 1.30-3.89) (p = 0.003)]和较高的 CRP 水平[OR:1.01 (95%CI: 1.00-1.01) (p = 0.005)]。大多数抗生素（65.9%）的处方来自 "观察 "组，最高的是头孢曲松和哌拉西林-他唑巴坦。只有 23.8%的患者经微生物学确诊感染，其中鲍曼不动杆菌和肺炎克雷伯菌是最常见的分离菌：该研究确定了在我们的环境中启动经验性抗菌治疗的预测因素，并强调了合理使用抗生素治疗的必要性。

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来源期刊

Expert Review of Anti-infective Therapy 医学-药学

CiteScore

11.20

自引率

0.00%

发文量

审稿时长

4-8 weeks

期刊介绍： Expert Review of Anti-Infective Therapy (ISSN 1478-7210) provides expert reviews on therapeutics and diagnostics in the treatment of infectious disease. Coverage includes antibiotics, drug resistance, drug therapy, infectious disease medicine, antibacterial, antimicrobial, antifungal and antiviral approaches, and diagnostic tests.