Predictors and patterns of empirical antibiotic therapy and associated outcomes in COVID-19 patients : a retrospective study in a tertiary care facility in South India
BACKGROUND: The coronavirus disease (COVID-19) led to a global health crisis. Inappropriate use of antibiotics in COVID-19 patients has been a concern, leading to antimicrobial resistance. This study evaluated the patterns and predictors of empirical antibiotic therapy in COVID-19 patients and associated outcomes.
METHODS: A hospital-based retrospective study was conducted with 525 patients admitted to Kasturba Hospital, Manipal, India, with moderate and severe COVID-19 from 1 March to 1 August 2021. They were divided based on empirical therapy, and predictors of antibiotic usage were assessed by logistic regression.
RESULTS: Four hundred and eighty (91.4%) COVID-19 patients received at least one course of antibiotics, with 440 (83.8%) initiating empirical therapy. Patients with severe COVID-19 manifestations were more likely to be prescribed empirical antibiotics. Multivariable analysis showed that patients initiated on empirical antibiotics had significantly elevated levels of procalcitonin [OR: 3.91 (95% CI: 1.66-9.16) (p = 0.001)], invasive ventilation [OR: 3.93 (95% CI: 1.70-9.09) (p = 0.001)], shortness of breath [OR: 2.25 (95% CI: 1.30-3.89) (p = 0.003)] and higher CRP levels [OR: 1.01 (95% CI: 1.00-1.01) (p = 0.005)]. Most antibiotics (65.9%) were prescribed from the 'Watch' group, the highest being ceftriaxone. Only 23.8% of the patients had microbiologically confirmed infections.
CONCLUSION: The study identified predictors for initiating empirical antibacterial therapy in our setting.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
Expert review of anti-infective therapy - (2024) vom: 08. Jan., Seite 1-9 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Lukose, Lipin [VerfasserIn] |
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| Links: |
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| Themen: |
Antimicrobial stewardship |
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| Anmerkungen: |
Date Revised 18.01.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1080/14787210.2024.2303019 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM366797077 |
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| 100 | 1 | |a Lukose, Lipin |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Predictors and patterns of empirical antibiotic therapy and associated outcomes in COVID-19 patients |b a retrospective study in a tertiary care facility in South India |
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| 500 | |a Date Revised 18.01.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a BACKGROUND: The coronavirus disease (COVID-19) led to a global health crisis. Inappropriate use of antibiotics in COVID-19 patients has been a concern, leading to antimicrobial resistance. This study evaluated the patterns and predictors of empirical antibiotic therapy in COVID-19 patients and associated outcomes | ||
| 520 | |a METHODS: A hospital-based retrospective study was conducted with 525 patients admitted to Kasturba Hospital, Manipal, India, with moderate and severe COVID-19 from 1 March to 1 August 2021. They were divided based on empirical therapy, and predictors of antibiotic usage were assessed by logistic regression | ||
| 520 | |a RESULTS: Four hundred and eighty (91.4%) COVID-19 patients received at least one course of antibiotics, with 440 (83.8%) initiating empirical therapy. Patients with severe COVID-19 manifestations were more likely to be prescribed empirical antibiotics. Multivariable analysis showed that patients initiated on empirical antibiotics had significantly elevated levels of procalcitonin [OR: 3.91 (95% CI: 1.66-9.16) (p = 0.001)], invasive ventilation [OR: 3.93 (95% CI: 1.70-9.09) (p = 0.001)], shortness of breath [OR: 2.25 (95% CI: 1.30-3.89) (p = 0.003)] and higher CRP levels [OR: 1.01 (95% CI: 1.00-1.01) (p = 0.005)]. Most antibiotics (65.9%) were prescribed from the 'Watch' group, the highest being ceftriaxone. Only 23.8% of the patients had microbiologically confirmed infections | ||
| 520 | |a CONCLUSION: The study identified predictors for initiating empirical antibacterial therapy in our setting | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a antimicrobial stewardship | |
| 650 | 4 | |a empirical antibiotic therapy | |
| 650 | 4 | |a microbiologically confirmed infections | |
| 650 | 4 | |a patterns | |
| 650 | 4 | |a predictors | |
| 700 | 1 | |a Kaur, Gursimran |e verfasserin |4 aut | |
| 700 | 1 | |a M, Mohammed Asif |e verfasserin |4 aut | |
| 700 | 1 | |a Abraham, Gail Ann |e verfasserin |4 aut | |
| 700 | 1 | |a Khera, Kanav |e verfasserin |4 aut | |
| 700 | 1 | |a Subeesh, Viswam K |e verfasserin |4 aut | |
| 700 | 1 | |a Castelino, Ronald L |e verfasserin |4 aut | |
| 700 | 1 | |a Karanth, Shubhada |e verfasserin |4 aut | |
| 700 | 1 | |a Udyavara Kudru, Chandrashekar |e verfasserin |4 aut | |
| 700 | 1 | |a Varma, Muralidhar |e verfasserin |4 aut | |
| 700 | 1 | |a Miraj, Sonal Sekhar |e verfasserin |4 aut | |
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