Antibiotic use in patients with COVID-19: a 'snapshot' Infectious Diseases International Research Initiative (ID-IRI) survey
Antibiotic use in patients with COVID-19: a 'snapshot' Infectious Diseases International Research Initiative (ID-IRI) survey
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DOI：
10.1093/jac/dkaa326
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发表时间：
2020-11-01
影响因子：
5.2
通讯作者：
Erdem, Hakan
中科院分区：
文献类型：
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作者：
Beovic, Bojana;Dousak, May;Erdem, Hakan
背景：COVID-19患者因疑似或确诊的细菌重复感染可能需要抗生素。目的：了解COVID-19患者的抗生素处方情况。方法：我们进行了一项国际网络调查，并调查了参与COVID-19治疗的医生报告的抗生素使用模式。采用SPSS统计软件25进行数据分析。结果：该调查由来自23个国家和82家不同医院的166名参与者完成。61.8% （n = 102）的参与者报告了COVID-19患者抗生素使用的当地指南，82.9% （n = 136）的参与者报告的指南与当地社区获得性肺炎指南没有差异。临床表现被认为是开始使用抗生素的最重要原因（在1 ~ 5级评分中平均得分4.07,SD =1.095）。当开始使用抗生素时，大多数应答者认为非典型病原体覆盖率的需求最高（平均得分= 2.8,SD = 0.99），其次是金黄色葡萄球菌（双峰式量表平均得分= 2.67,SD = 1.05, 1和2表示不同意，3和4表示同意）。在病房的患者中，29.1%的受访者选择不开任何抗生素。52.4% （n = 87）的应答者报告β -内酰胺类药物与大环内酯类或氟喹诺酮类药物联合使用。在ICU的患者中，哌拉西林/他唑巴坦是最常用的抗生素。报告的抗生素治疗平均持续时间为7.12 （SD = 2.44）天。结论：该研究揭示了COVID-19患者广泛使用广谱抗生素。实施抗菌药物管理原则是必要的，以减轻抗生素治疗的负面后果。
Background: Antibiotics may be indicated in patients with COVID-19 due to suspected or confirmed bacterial superinfection.Objectives: To investigate antibiotic prescribing practices in patients with COVID-19.Methods: We performed an international web-based survey and investigated the pattern of antibiotic use as reported by physicians involved in treatment of COVID-19. SPSS Statistics version 25 was used for data analysis.Results: The survey was completed by 166 participants from 23 countries and 82 different hospitals. Local guidelines for antibiotic use in COVID-19 patients were reported by 61.8% (n = 102) of participants and for 82.9% (n = 136) they did not differ from Local community-acquired pneumonia guidelines. Clinical presentation was recognized as the most important reason for the start of antibiotics (mean score 4.07 and SD =1.095 on grading scale from 1 to 5). When antibiotics were started, most respondents rated as the highest the need for coverage of atypical pathogens (mean score = 2.8 and SD = 0.99), followed by Staphylococcus aureus (mean score = 2.67 and SD = 1.05 on bi-modal scale, with values 1 and 2 for disagreement and values 3 and 4 for agreement). In the patients on the ward, 29.1% of respondents chose not to prescribe any antibiotic. Combination of beta-Lactams and macrolides or fluoroquinolones was reported by 52.4% (n = 87) of respondents. In patients in the ICU, piperacillin/tazobactam was the most commonly prescribed antibiotic. The mean reported duration of antibiotic treatment was 7.12 (SD = 2.44) days.Conclusions: The study revealed widespread broad-spectrum antibiotic use in patients with COVID-19. Implementation of antimicrobial stewardship principles is warranted to mitigate the negative consequences of antibiotic therapy.