Inappropriate antibiotic use in the COVID-19 era : Factors associated with inappropriate prescribing and secondary complications. Analysis of the registry SEMI-COVID

BACKGROUND: 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.

METHODS: 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.

RESULTS: 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).

CONCLUSION: 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.

Medienart:

E-Artikel

Erscheinungsjahr:

2021

Erschienen:

2021

Enthalten in:

Zur Gesamtaufnahme - volume:16

Enthalten in:

PloS one - 16(2021), 5 vom: 31., Seite e0251340

Sprache:

Englisch

Beteiligte Personen:

Calderón-Parra, Jorge [VerfasserIn]
Muiño-Miguez, Antonio [VerfasserIn]
Bendala-Estrada, Alejandro D [VerfasserIn]
Ramos-Martínez, Antonio [VerfasserIn]
Muñez-Rubio, Elena [VerfasserIn]
Fernández Carracedo, Eduardo [VerfasserIn]
Tejada Montes, Javier [VerfasserIn]
Rubio-Rivas, Manuel [VerfasserIn]
Arnalich-Fernandez, Francisco [VerfasserIn]
Beato Pérez, Jose Luis [VerfasserIn]
García Bruñén, Jose Miguel [VerfasserIn]
Del Corral Beamonte, Esther [VerfasserIn]
Pesqueira Fontan, Paula Maria [VerfasserIn]
Carmona, Maria Del Mar [VerfasserIn]
Fernández-Madera Martínez, Rosa [VerfasserIn]
González García, Andrés [VerfasserIn]
Salazar Mosteiro, Cristina [VerfasserIn]
Tuñón de Almeida, Carlota [VerfasserIn]
González Moraleja, Julio [VerfasserIn]
Deodati, Francesco [VerfasserIn]
Martín Escalante, María Dolores [VerfasserIn]
Asensio Tomás, María Luisa [VerfasserIn]
Gómez Huelgas, Ricardo [VerfasserIn]
Casas Rojo, José Manuel [VerfasserIn]
Millán Núñez-Cortés, Jesús [VerfasserIn]
SEMI-COVID-19 Network [VerfasserIn]

Links:

Volltext

Themen:

9007-41-4
Anti-Bacterial Agents
C-Reactive Protein
Journal Article

Anmerkungen:

Date Completed 24.05.2021

Date Revised 11.11.2023

published: Electronic-eCollection

Citation Status MEDLINE

doi:

10.1371/journal.pone.0251340

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM325261733