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Antibiotic prescriptions in children with COVID-19 and Multisystem Inflammatory Syndrome: a multinational experience in 990 cases from Latin America
Adriana Yock; Jacopo Lenzi; Rolando Ulloa-Gutierrez; Jessica Gomez-Vargas; Omar Antunez-Montes; Jorge Alberto Rios Aida; Olguita del Aguila; Erick Arteaga-Menchaca; Francisco Campos; Fadia Uribe; Andrea Parra Buitrago; Lina Maria Betancur Londono; Martin Brizuela; Danilo Buonsenso.
  • Adriana Yock; Pediatric Emergency Department, Hospital Nacional de Ninos "Dr. Carlos Saenz Herrera", CCSS, San Jose, Costa Rica.
  • Jacopo Lenzi; Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy
  • Rolando Ulloa-Gutierrez; Infectious Disease Department. Hospital Nacional de Ninos "Dr. Carlos Saenz Herrera", CCSS, San Jose, Costa Rica.
  • Jessica Gomez-Vargas; Pediatric Emergency Department, Hospital Nacional de Ninos "Dr. Carlos Saenz Herrera", CCSS, San Jose, Costa Rica.
  • Omar Antunez-Montes; Departamento de Docencia e Investigacion, Instituto Latinoamericano de Ecografia en Medicina (ILEM), Ciudad de Mexico, Mexico
  • Jorge Alberto Rios Aida; CLINICA JAS MEDICA, Lima, Peru
  • Olguita del Aguila; Unidad de Infectologia Pediatrica del Hospital Nacional Edgardo Rebagliati Martins-Lima-Peru
  • Erick Arteaga-Menchaca; Hospital General Regional 200 IMSS, Mexico
  • Francisco Campos; Hospital Madre Nino San Bartolome, Lima, Peru
  • Fadia Uribe; Hospital Madre Nino San Bartolome, Lima, Peru
  • Andrea Parra Buitrago; Hospital Pablo Tobon Uribe Medellin, Colombia
  • Lina Maria Betancur Londono; Hospital Pablo Tobon Uribe Medellin, Colombia
  • Martin Brizuela; Pediatric Infectious Disease, Hospital isidoro Iriarte, Quilmes, Buenos Aires, Argentina
  • Danilo Buonsenso; Fondazione Policlinico Universitario A. Gemelli
Preprint in English | medRxiv | ID: ppmedrxiv-20243568
ABSTRACT
BackgroundTo date, there are no comprehensive data on antibiotic use in children with COVID-19 and Multisystem Inflammatory Syndrome (MIS-C). MethodsMulticenter cohort study from 5 Latin American countries. Children 17 years of age or younger with microbiologically confirmed SARS-CoV-2 infection or fulfilling MIS-C definition were included. Antibiotic prescriptions were collected and factors associated with their use were calculated. Findings990 children were included, with a median age of 3 years (interquartile range 1-9). Of these, 69 (7.0%) were diagnosed with MIS-C. The prevalence of antibiotic use was 24.5% (n = 243). MIS-C with (OR = 45.48) or without (OR = 10.35) cardiac involvement, provision of intensive care (OR = 9.60), need for hospital care (OR = 6.87), pneumonia and/or ARDS detected through chest X-rays (OR = 4.40), administration of systemic corticosteroids (OR = 4.39), oxygen support, mechanical ventilation or CPAP (OR = 2.21), pyrexia (OR = 1.84), and female sex (OR = 1.50) were independently associated with increased use of antibiotics. On the contrary, lower respiratory tract infections without radiologic evidence of pneumonia/ARDS and not requiring respiratory support (OR = 0.34) were independently associated with decreased use of antibiotics. There was significant variation in antibiotic use across the hospitals. ConclusionsOur study showed a relatively high rate of antibiotic prescriptions in children with COVID-19 and in particular in those with severe disease or MIS-C. Importantly, we found a significant variation in reasons for prescriptions of antibiotics and type of chosen therapies, as well in hospital practices, highlighting current uncertainties and lack of guidelines for the recognition of bacterial infections in children with COVID-19. Prospective studies are needed to provide better evidence on the recognition and management of bacterial infections in COVID-19 children. What is knownCOVID-19 may worsen antibiotic prescription practices What this newCOVID-19 and MIS-C children frequently received antibiotics There was a wide variation in antibiotic prescriptions among institutions, highlighting the lack of practicle guidelines in the use of antibiotics in children with COVID-19
Full text: Available Collection: Preprints Database: medRxiv Type of study: Clinical Practice Guide / Observational study / Risk factors Language: English Year: 2020 Document Type: Preprint

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Full text: Available Collection: Preprints Database: medRxiv Type of study: Clinical Practice Guide / Observational study / Risk factors Language: English Year: 2020 Document Type: Preprint