Inappropriate antibiotic use in the COVID-19 era: Factors associated with inappropriate prescribing and secondary complications. Analysis of the registry SEMI-COVID.
Inappropriate antibiotic use in the COVID-19 era: Factors associated with inappropriate prescribing and secondary complications. Analysis of the registry SEMI-COVID.
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DOI：
10.1371/journal.pone.0251340
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
SEMI-COVID-19 Network
中科院分区：
文献类型：
--
作者：
Calderón-Parra J;Muiño-Miguez A;Bendala-Estrada AD;Ramos-Martínez A;Muñez-Rubio E;Fernández Carracedo E;Tejada Montes J;Rubio-Rivas M;Arnalich-Fernandez F;Beato Pérez JL;García Bruñén JM;Del Corral Beamonte E;Pesqueira Fontan PM;Carmona MDM;Fernández-Madera Martínez R;González García A;Salazar Mosteiro C;Tuñón de Almeida C;González Moraleja J;Deodati F;Martín Escalante MD;Asensio Tomás ML;Gómez Huelgas R;Casas Rojo JM;Millán Núñez-Cortés J;SEMI-COVID-19 Network
尽管细菌合并感染很少见，但大多数 COVID-19 患者都会接受抗生素治疗。这可能会导致并发症增加，包括抗菌素耐药性。我们的目的是分析这些患者抗生素处方不当的危险因素，并描述使用抗生素可能引起的并发症。 SEMI-COVID-19 登记处是一个多中心、回顾性患者队列。根据适当或不适当的处方，抗生素患者被分为两组，具体取决于患者是否符合其使用标准。通过多水平逻辑回归分析进行比较。还确定了使用抗生素可能出现的并发症。在 13,932 名患者中，3047 名患者（21.6%）没有服用抗生素，6116 名患者（43.9%）服用了适当的抗生素，4769 名患者（34.2%）服用了不适当的抗生素。以下是处方不当的独立因素：2020年2月至3月入院（OR 1.54，95%CI 1.18–2.00）、年龄（OR 0.98，95%CI 0.97–0.99）、无合并症（OR 1.43，95%CI 1.05–1.94）、干咳（OR 2.51， 95%CI 1.94–3.26)，发烧（或 1.33，95%CI 1.13–1.56)、呼吸困难（OR 1.31，95%CI 1.04–1.69）、流感样症状（OR 2.70，95%CI 1.75–4.17）和 C 反应蛋白水平升高（每增加 mg/L OR 1.01，95% CI 1.00–1.01）。接受抗生素治疗的患者出现药物不良反应的频率更高（4.9% vs 2.7%，p < .001）。 COVID-19 患者不恰当使用抗生素的情况非常频繁，导致不良反应的风险增加。定义它们在这些患者中的使用标准至关重要。了解与不当处方相关的因素可能会有所帮助。
Most patients with COVID-19 receive antibiotics despite the fact that bacterial co-infections are rare. This can lead to increased complications, including antibacterial resistance. We aim to analyze risk factors for inappropriate antibiotic prescription in these patients and describe possible complications arising from their use. The SEMI-COVID-19 Registry is a multicenter, retrospective patient cohort. Patients with antibiotic were divided into two groups according to appropriate or inappropriate prescription, depending on whether the patient fulfill any criteria for its use. Comparison was made by means of multilevel logistic regression analysis. Possible complications of antibiotic use were also identified. Out of 13,932 patients, 3047 (21.6%) were prescribed no antibiotics, 6116 (43.9%) were appropriately prescribed antibiotics, and 4769 (34.2%) were inappropriately prescribed antibiotics. The following were independent factors of inappropriate prescription: February-March 2020 admission (OR 1.54, 95%CI 1.18–2.00), age (OR 0.98, 95%CI 0.97–0.99), absence of comorbidity (OR 1.43, 95%CI 1.05–1.94), dry cough (OR 2.51, 95%CI 1.94–3.26), fever (OR 1.33, 95%CI 1.13–1.56), dyspnea (OR 1.31, 95%CI 1.04–1.69), flu-like symptoms (OR 2.70, 95%CI 1.75–4.17), and elevated C-reactive protein levels (OR 1.01 for each mg/L increase, 95% CI 1.00–1.01). Adverse drug reactions were more frequent in patients who received ANTIBIOTIC (4.9% vs 2.7%, p < .001). The inappropriate use of antibiotics was very frequent in COVID-19 patients and entailed an increased risk of adverse reactions. It is crucial to define criteria for their use in these patients. Knowledge of the factors associated with inappropriate prescribing can be helpful.
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影响因子：
3.5
作者：
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通讯作者：
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DOI：
10.1016/j.cmi.2020.07.016
发表时间：
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期刊：
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
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期刊：
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作者：
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通讯作者：
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DOI：
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发表时间：
2021-04
期刊：
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
影响因子：
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作者：
Langford BJ;So M;Raybardhan S;Leung V;Soucy JR;Westwood D;Daneman N;MacFadden DR
通讯作者：
MacFadden DR