Your browser doesn't support javascript.
Bacterial co-infection and antibiotic stewardship in patients with COVID-19: a systematic review and meta-analysis.
Calderon, Maria; Gysin, Grace; Gujjar, Akash; McMaster, Ashleigh; King, Lisa; Comandé, Daniel; Hunter, Ewan; Payne, Brendan.
  • Calderon M; Department of Infection and Tropical Medicine, Newcastle-Upon-Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Queen Victoria Rd., Newcastle-Upon-Tyne, NE1 4LP, UK. maria.calderon@nhs.net.
  • Gysin G; Translational and Clinical Research Institute, Newcastle University, Newcastle-Upon-Tyne, NE1 7RU, UK.
  • Gujjar A; School of Medicine, Newcastle University, Newcastle-Upon-Tyne, UK.
  • McMaster A; School of Medicine, Newcastle University, Newcastle-Upon-Tyne, UK.
  • King L; Department of Infection and Tropical Medicine, Newcastle-Upon-Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Queen Victoria Rd., Newcastle-Upon-Tyne, NE1 4LP, UK.
  • Comandé D; School of Medicine, Newcastle University, Newcastle-Upon-Tyne, UK.
  • Hunter E; Instituto de Efectividad Clinica y Sanitaria, Emilio Ravignani 2024 (C1414CPV), Buenos Aires, Argentina.
  • Payne B; Department of Infection and Tropical Medicine, Newcastle-Upon-Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Queen Victoria Rd., Newcastle-Upon-Tyne, NE1 4LP, UK.
BMC Infect Dis ; 23(1): 14, 2023 Jan 09.
Article in English | MEDLINE | ID: covidwho-2196083
ABSTRACT

INTRODUCTION:

Understanding the proportion of patients with COVID-19 who have respiratory bacterial co-infections and the responsible pathogens is important for managing COVID-19 effectively while ensuring responsible antibiotic use.

OBJECTIVE:

To estimate the frequency of bacterial co-infection in COVID-19 hospitalized patients and of antibiotic prescribing during the early pandemic period and to appraise the use of antibiotic stewardship criteria.

METHODS:

Systematic review and meta-analysis was performed using major databases up to May 5, 2021. We included studies that reported proportion/prevalence of bacterial co-infection in hospitalized COVID-19 patients and use of antibiotics. Where available, data on duration and type of antibiotics, adverse events, and any information about antibiotic stewardship policies were also collected.

RESULTS:

We retrieved 6,798 studies and included 85 studies with data from more than 30,000 patients. The overall prevalence of bacterial co-infection was 11% (95% CI 8% to 16%; 70 studies). When only confirmed bacterial co-infections were included the prevalence was 4% (95% CI 3% to 6%; 20 studies). Overall antibiotic use was 60% (95% CI 52% to 68%; 52 studies). Empirical antibiotic use rate was 62% (95% CI 55% to 69%; 11 studies). Few studies described criteria for stopping antibiotics.

CONCLUSION:

There is currently insufficient evidence to support widespread empirical use of antibiotics in most hospitalised patients with COVID-19, as the overall proportion of bacterial co-infection is low. Furthermore, as the use of antibiotics during the study period appears to have been largely empirical, clinical guidelines to promote and support more targeted administration of antibiotics in patients admitted to hospital with COVID-19 are required.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiratory Tract Infections / Bacterial Infections / Coinfection / Antimicrobial Stewardship / COVID-19 Type of study: Observational study / Prognostic study / Reviews / Systematic review/Meta Analysis Limits: Humans Language: English Journal: BMC Infect Dis Journal subject: Communicable Diseases Year: 2023 Document Type: Article Affiliation country: S12879-022-07942-x

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiratory Tract Infections / Bacterial Infections / Coinfection / Antimicrobial Stewardship / COVID-19 Type of study: Observational study / Prognostic study / Reviews / Systematic review/Meta Analysis Limits: Humans Language: English Journal: BMC Infect Dis Journal subject: Communicable Diseases Year: 2023 Document Type: Article Affiliation country: S12879-022-07942-x