Your browser doesn't support javascript.
Empiric Antibacterial Therapy and Community-onset Bacterial Coinfection in Patients Hospitalized With Coronavirus Disease 2019 (COVID-19): A Multi-hospital Cohort Study.
Vaughn, Valerie M; Gandhi, Tejal N; Petty, Lindsay A; Patel, Payal K; Prescott, Hallie C; Malani, Anurag N; Ratz, David; McLaughlin, Elizabeth; Chopra, Vineet; Flanders, Scott A.
  • Vaughn VM; Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA.
  • Gandhi TN; VA Ann Arbor Health System, Ann Arbor, Michigan, USA.
  • Petty LA; Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA.
  • Patel PK; Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA.
  • Prescott HC; Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA.
  • Malani AN; VA Ann Arbor Health System, Ann Arbor, Michigan, USA.
  • Ratz D; Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA.
  • McLaughlin E; VA Ann Arbor Health System, Ann Arbor, Michigan, USA.
  • Chopra V; Division of Infectious Diseases, Department of Internal Medicine, St Joseph Mercy Health System, Ann Arbor, Michigan, USA.
  • Flanders SA; Department of Infection Prevention and Control, St Joseph Mercy Health System, Ann Arbor, Michigan, USA.
Clin Infect Dis ; 72(10): e533-e541, 2021 05 18.
Article in English | MEDLINE | ID: covidwho-1232185
Semantic information from SemMedBD (by NLM)
1. Bacterial Infections PROCESS_OF Patients
Subject
Bacterial Infections
Predicate
PROCESS_OF
Object
Patients
2. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
3. COVID-19 PROCESS_OF hospitalized patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
hospitalized patients
4. Bacterial Infections PROCESS_OF hospitalized patients
Subject
Bacterial Infections
Predicate
PROCESS_OF
Object
hospitalized patients
5. Early Therapy USES Anti-Bacterial Agents
Subject
Early Therapy
Predicate
USES
Object
Anti-Bacterial Agents
6. Early Therapy ADMINISTERED_TO Patients
Subject
Early Therapy
Predicate
ADMINISTERED_TO
Object
Patients
7. Bacterial Infections PROCESS_OF Patients
Subject
Bacterial Infections
Predicate
PROCESS_OF
Object
Patients
8. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
9. COVID-19 PROCESS_OF hospitalized patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
hospitalized patients
10. Bacterial Infections PROCESS_OF hospitalized patients
Subject
Bacterial Infections
Predicate
PROCESS_OF
Object
hospitalized patients
11. Early Therapy USES Anti-Bacterial Agents
Subject
Early Therapy
Predicate
USES
Object
Anti-Bacterial Agents
12. Early Therapy ADMINISTERED_TO Patients
Subject
Early Therapy
Predicate
ADMINISTERED_TO
Object
Patients
ABSTRACT

BACKGROUND:

Antibacterials may be initiated out of concern for bacterial coinfection in coronavirus disease 2019 (COVID-19). We determined prevalence and predictors of empiric antibacterial therapy and community-onset bacterial coinfections in hospitalized patients with COVID-19.

METHODS:

A randomly sampled cohort of 1705 patients hospitalized with COVID-19 in 38 Michigan hospitals between 3/13/2020 and 6/18/2020. Data were collected on early (within 2 days of hospitalization) empiric antibacterial therapy and community-onset bacterial coinfections (positive microbiologic test ≤3 days). Poisson generalized estimating equation models were used to assess predictors.

RESULTS:

Of 1705 patients with COVID-19, 56.6% were prescribed early empiric antibacterial therapy; 3.5% (59/1705) had a confirmed community-onset bacterial infection. Across hospitals, early empiric antibacterial use varied from 27% to 84%. Patients were more likely to receive early empiric antibacterial therapy if they were older (adjusted rate ratio [ARR] 1.04 [1.00-1.08] per 10 years); had a lower body mass index (ARR 0.99 [0.99-1.00] per kg/m2), more severe illness (eg, severe sepsis; ARR 1.16 [1.07-1.27]), a lobar infiltrate (ARR 1.21 [1.04-1.42]); or were admitted to a for-profit hospital (ARR 1.30 [1.15-1.47]). Over time, COVID-19 test turnaround time (returned ≤1 day in March [54.2%, 461/850] vs April [85.2%, 628/737], P < .001) and empiric antibacterial use (ARR 0.71 [0.63-0.81] April vs March) decreased.

CONCLUSIONS:

The prevalence of confirmed community-onset bacterial coinfections was low. Despite this, half of patients received early empiric antibacterial therapy. Antibacterial use varied widely by hospital. Reducing COVID-19 test turnaround time and supporting stewardship could improve antibacterial use.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Coinfection / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Country/Region as subject: North America Language: English Journal: Clin Infect Dis Journal subject: Communicable Diseases Year: 2021 Document Type: Article Affiliation country: Cid

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Main subject: Coinfection / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Country/Region as subject: North America Language: English Journal: Clin Infect Dis Journal subject: Communicable Diseases Year: 2021 Document Type: Article Affiliation country: Cid