Your browser doesn't support javascript.
Antibiotic prescribing in patients with COVID-19: rapid review and meta-analysis.
Langford, Bradley J; So, Miranda; Raybardhan, Sumit; Leung, Valerie; Soucy, Jean-Paul R; Westwood, Duncan; Daneman, Nick; MacFadden, Derek R.
  • Langford BJ; Public Health Ontario, ON, Canada; Hotel Dieu Shaver Health and Rehabilitation Centre, ON, Canada. Electronic address: brad.langford@gmail.com.
  • So M; Sinai Health-University Health Network Antimicrobial Stewardship Program, University Health Network, Toronto, Canada; University of Toronto, ON, Canada; Toronto General Hospital Research Institute, Toronto, ON, Canada.
  • Raybardhan S; North York General Hospital, ON, Canada.
  • Leung V; Public Health Ontario, ON, Canada; Toronto East Health Network, Michael Garron Hospital, ON, Canada.
  • Soucy JR; Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, ON, Canada.
  • Westwood D; Sunnybrook Research Institute, ON, Canada.
  • Daneman N; Public Health Ontario, ON, Canada; University of Toronto, ON, Canada; Sunnybrook Research Institute, ON, Canada; ICES (formerly Institute for Clinical Evaluative Sciences), ON, Canada.
  • MacFadden DR; Ottawa Hospital Research Institute, ON, Canada.
Clin Microbiol Infect ; 27(4): 520-531, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1009396
ABSTRACT

BACKGROUND:

The proportion of patients infected with SARS-CoV-2 that are prescribed antibiotics is uncertain, and may contribute to patient harm and global antibiotic resistance.

OBJECTIVE:

The aim was to estimate the prevalence and associated factors of antibiotic prescribing in patients with COVID-19. DATA SOURCES We searched MEDLINE, OVID Epub and EMBASE for published literature on human subjects in English up to June 9 2020. STUDY ELIGIBILITY CRITERIA We included randomized controlled trials; cohort studies; case series with ≥10 patients; and experimental or observational design that evaluated antibiotic prescribing.

PARTICIPANTS:

The study participants were patients with laboratory-confirmed SARS-CoV-2 infection, across all healthcare settings (hospital and community) and age groups (paediatric and adult).

METHODS:

The main outcome of interest was proportion of COVID-19 patients prescribed an antibiotic, stratified by geographical region, severity of illness and age. We pooled proportion data using random effects meta-analysis.

RESULTS:

We screened 7469 studies, from which 154 were included in the final analysis. Antibiotic data were available from 30 623 patients. The prevalence of antibiotic prescribing was 74.6% (95% CI 68.3-80.0%). On univariable meta-regression, antibiotic prescribing was lower in children (prescribing prevalence odds ratio (OR) 0.10, 95% CI 0.03-0.33) compared with adults. Antibiotic prescribing was higher with increasing patient age (OR 1.45 per 10 year increase, 95% CI 1.18-1.77) and higher with increasing proportion of patients requiring mechanical ventilation (OR 1.33 per 10% increase, 95% CI 1.15-1.54). Estimated bacterial co-infection was 8.6% (95% CI 4.7-15.2%) from 31 studies.

CONCLUSIONS:

Three-quarters of patients with COVID-19 receive antibiotics, prescribing is significantly higher than the estimated prevalence of bacterial co-infection. Unnecessary antibiotic use is likely to be high in patients with COVID-19.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Drug Prescriptions / Drug Utilization / COVID-19 / Anti-Bacterial Agents Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials / Reviews Topics: Long Covid Limits: Female / Humans / Male Language: English Journal: Clin Microbiol Infect Journal subject: Communicable Diseases / Microbiology Year: 2021 Document Type: Article

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Main subject: Drug Prescriptions / Drug Utilization / COVID-19 / Anti-Bacterial Agents Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials / Reviews Topics: Long Covid Limits: Female / Humans / Male Language: English Journal: Clin Microbiol Infect Journal subject: Communicable Diseases / Microbiology Year: 2021 Document Type: Article