Risk stratification for selecting empiric antibiotherapy during and after COVID-19.
Curr Opin Infect Dis
; 35(6): 605-613, 2022 Dec 01.
Article
in English
| MEDLINE | ID: covidwho-2051764
ABSTRACT
PURPOSE OF REVIEW SARS-CoV-2 deeply modified the risk of bacterial infection, bacterial resistance, and antibiotic strategies. This review summarized what we have learned. RECENT FINDINGS:
During the COVID-19 pandemic, we observed an increase in healthcare-acquired infection and multidrug-resistant organism-related infection, triggered by several factors structural factors, such as increased workload and ongoing outbreaks, underlying illnesses, invasive procedures, and treatment-induced immunosuppression. The two most frequently healthcare-acquired infections described in patients hospitalized with COVID-19 were bloodstream infection, related or not to catheters, health-acquired pneumonia (in ventilated or nonventilated patients). The most frequent species involved in bacteremia were Gram-positive cocci and Gram-negative bacilli in health-acquired pneumonia. The rate of Gram-negative bacilli is particularly high in late-onset ventilator-associated pneumonia, and the specific risk of Pseudomonas aeruginosa- related pneumonia increased when the duration of ventilation was longer than 7 days. A specificity that remains unexplained so far is the increase in enterococci bacteremia.SUMMARY:
The choice of empiric antibiotimicrobials depends on several factors such as the site of the infection, time of onset and previous length of stay, previous antibiotic therapy, and known multidrug-resistant organism colonization. Pharmacokinetics of antimicrobials could be markedly altered during SARS-CoV-2 acute respiratory failure, which should encourage to perform therapeutic drug monitoring.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Cross Infection
/
Gram-Negative Bacterial Infections
/
Bacteremia
/
COVID-19 Drug Treatment
Type of study:
Observational study
/
Prognostic study
/
Randomized controlled trials
Limits:
Humans
Language:
English
Journal:
Curr Opin Infect Dis
Journal subject:
Communicable Diseases
Year:
2022
Document Type:
Article
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