Antimicrobial Use in COVID-19 Patients in the First Phase of the SARS-CoV-2 Pandemic: A Scoping Review.
Antimicrobial Use in COVID-19 Patients in the First Phase of the SARS-CoV-2 Pandemic: A Scoping Review.
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DOI：
10.3390/antibiotics10060745
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发表时间：
2021-06-19
期刊：
影响因子：
--
通讯作者：
Lambert H
中科院分区：
文献类型：
--
作者：
Cong W;Poudel AN;Alhusein N;Wang H;Yao G;Lambert H
本次范围审查为COVID-19患者治疗中全球抗微生物药物使用的流行程度和模式提供了新证据；确定大流行第一阶段最常用的抗生素和与抗生素处方相关的临床情况；并探讨了记录在案的抗生素处方对COVID-19患者治疗结果的影响。该审查符合PRISMA范围审查指南，该方案已在开放科学框架注册。在大流行的前六个月，重症或危重症患者（75.4%）与轻度或中度疾病患者（75.1%）之间的平均抗生素处方率相似。无临床理由处方抗生素的患者比例为51.5%，轻、中度疾病和重症、危重症患者比例为41.9%。有临床理由给予抗生素的患者与无临床理由给予抗生素的患者比较，死亡率较低（9.5%对13.1%），出院率较高（80.9%对69.3%），住院时间较短（9.3天对12.2天）。在大流行的前6个月，无论病情严重与否，都为COVID-19患者开了抗生素。在轻中度COVID-19患者的抗生素处方中，有很大一部分没有细菌合并感染的临床证据。如果没有细菌合并感染的临床证据，抗生素可能对COVID-19患者无效。
This scoping review provides new evidence on the prevalence and patterns of global antimicrobial use in the treatment of COVID-19 patients; identifies the most commonly used antibiotics and clinical scenarios associated with antibiotic prescribing in the first phase of the pandemic; and explores the impact of documented antibiotic prescribing on treatment outcomes in COVID-19 patients. The review complies with PRISMA guidelines for Scoping Reviews and the protocol is registered with the Open Science Framework. In the first six months of the pandemic, there was a similar mean antibiotic prescribing rate between patients with severe or critical illness (75.4%) and patients with mild or moderate illness (75.1%). The proportion of patients prescribed antibiotics without clinical justification was 51.5% vs. 41.9% for patients with mild or moderate illness and those with severe or critical illness. Comparison of patients who were provided antibiotics with a clinical justification with those who were given antibiotics without clinical justification showed lower mortality rates (9.5% vs. 13.1%), higher discharge rates (80.9% vs. 69.3%), and shorter length of hospital stay (9.3 days vs. 12.2 days). In the first 6 months of the pandemic, antibiotics were prescribed for COVID-19 patients regardless of severity of illness. A large proportion of antibiotic prescribing for mild and moderate COVID-19 patients did not have clinical evidence of a bacterial co-infection. Antibiotics may not be beneficial to COVID-19 patients without clinical evidence of a bacterial co-infection.
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DOI：
10.1016/j.cmi.2020.07.016
发表时间：
2020-12
期刊：
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
影响因子：
--
作者：
Langford BJ;So M;Raybardhan S;Leung V;Westwood D;MacFadden DR;Soucy JR;Daneman N
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影响因子：
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通讯作者：
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DOI：
10.1016/j.cmi.2020.07.041
发表时间：
2021-01
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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影响因子：
158.5
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影响因子：
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