Vnitr Lek 2021, 67(8):448-454 | DOI: 10.36290/vnl.2021.118
Antibiotic treatment issues in patients with COVID-19
- 1 Ústav mikrobiologie, Fakultní nemocnice Olomouc
- 2 Klinika anesteziologie, resuscitace a intenzivní medicíny, Fakultní nemocnice Olomouc
- 3 Klinika plicních nemocí a tuberkulózy, Fakultní nemocnice Olomouc
The COVID-19 pandemic may increase the current threat of antimicrobial resistance and exacerbate another, rather silent, pandemic posed by the increasing frequency of multidrug-resistant bacterial pathogens and the associated potential for loss of effective antibiotics. Antibiotic treatment has often been used in patients hospitalized for COVID-19 due to concerns about possible bacterial co-infection, as confirmed by previous experience with viral respiratory infections such as H1N1 influenza, SARS and MERS. Concerns or unknowns related to the COVID-19 pandemic have also affected physicians' behavior, including the use of antibiotics. However, the high rate of antibiotic use in patients, especially those with mild to moderate COVID-19 disease, is inconsistent with the actual incidence of bacterial co-infections and/or secondary respiratory infections. Thus, it is clear that a careful assessment of the role of antibiotic treatment in patients hospitalized for COVID-19 is required. According to the current WHO recommendation, the application of antibiotics is especially suitable for patients with severe/critical degree of respiratory insufficiency requiring intensive oxygen therapy, artificial lung ventilation or support by extracorporeal membrane oxygenation.
Keywords: COVID-19, bacteria, pneumonia, antibiotics.
Published: December 9, 2021 Show citation
References
- Rice TW, Rubinson L, Uyeki TM et al. Critical illness from 2009 pandemic influenza A virus and bacterial coinfection in the United States. Crit Care Med 2012; 40(5): 1487-1498. Dostupné z DOI: .
Go to original source...
Go to PubMed...
- Shah NS, Greenberg JA, McNulty MC et al. Bacterial and viral co‑infections complicating severe influenza: Incidence and impact among 507 U.S. patients, 2013-2014. J Clin Virol 2016; 80: 12-19. Dostupné z DOI: .
Go to original source...
Go to PubMed...
- Uyeki TM, Bernstein HH, Bradley JS, et al. Clinical Practice Guidelines by the Infectious Diseases Society of America: 2018 Update on Diagnosis, Treatment, Chemoprophylaxis, and Institutional Outbreak Management of Seasonal Influenzaa. Clin Infect Dis 2019; 68(6): e1-e47. Dostupné z DOI: .
Go to original source...
Go to PubMed...
- Zhou F, Yu T, Du R et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020; 395(10229): 1054-1062. Dostupné z DOI: .
Go to original source...
Go to PubMed...
- Arshad S, Kilgore P, Chaudhry ZS et al. Treatment with hydroxychloroquine, azithromycin, and combination in patients hospitalized with COVID-19. Int J Infect Dis 2020; 97: 396-403. Dostupné z DOI: .
Go to original source...
Go to PubMed...
- Chen J, Liu D, Liu L et al. [A pilot study of hydroxychloroquine in treatment of patients with moderate COVID-19]. Zhejiang Da Xue Xue Bao Yi Xue Ban 2020; 49(2): 215-219. Dostupné z DOI: .
- Gautret P, Lagier JC, Parola P et al. Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open‑label non‑randomized clinical trial. Int J Antimicrob Agents 2020; 56(1): 105949. Dostupné z DOI: .
Go to original source...
Go to PubMed...
- Yang X, Yu Y, Xu J et al. Clinical course and outcomes of critically ill patients with SARS‑CoV-2 pneumonia in Wuhan, China: a single‑centered, retrospective, observational study. Lancet Respir Med. 2020; 8(5): 475-481. Dostupné z DOI: .
Go to original source...
Go to PubMed...
- Chen N, Zhou M, Dong X et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020; 395(10223): 507-513. Dostupné z DOI: < https://doi.org/10.1016/S0140-6736(20)30211-7>.
Go to original source...
Go to PubMed...
- Nori P, Cowman K, Chen V, et al. Bacterial and fungal coinfections in COVID-19 patients hospitalized during the New York City pandemic surge. Infect Control Hosp Epidemiol 2021; 42(1): 84-88. Dostupné z DOI: .
Go to original source...
Go to PubMed...
- Lansbury L, Lim B, Baskaran V, Lim WS. Co‑infections in people with COVID-19: a systematic review and meta‑analysis. J Infect 2020; 81(2): 266-275. Dostupné z DOI: < https://doi.org/10.1016/j.jinf.2020. 05. 046>.
Go to original source...
Go to PubMed...
- Vaughn VM, Gandhi T, Petty LA et al. Empiric Antibacterial Therapy and Community‑onset Bacterial Co‑infection in Patients Hospitalized with COVID-19: A Multi‑Hospital Cohort Study. Clin Infect Dis 2021; 72(10): e533-e541. Dostupné z DOI: < https://doi.org/10.1093/cid/ciaa1239>.
Go to original source...
Go to PubMed...
- Buetti N, Mazzuchelli T, Lo Priore E et al. Early administered antibiotics do not impact mortality in critically ill patients with COVID-19. J Infect 2020; 81(2): e148-e149. Dostupné z DOI: .
Go to original source...
Go to PubMed...
- Garcia‑Vidal C, Sanjuan G, Moreno‑García E et al. Incidence of co‑infections and superinfections in hospitalized patients with COVID-19: a retrospective cohort study. Clin Microbiol Infect 2021; 27(1): 83-88. Dostupné z DOI: < https://doi.org/10.1016/j.cmi.2020. 07. 041>.
Go to original source...
- Chedid M, Waked R, Haddad E et al. Antibiotics in treatment of COVID-19 complications: a review of frequency, indications, and efficacy. J Infect Public Health 2021; 14(5): 570-576. Dostupné z DOI: < https://doi.org/10.1016/j.jiph.2021. 02. 001>.
Go to original source...
- Wang D, Hu B, Hu C et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA 2020; 323(11): 1061-1069. Dopstupné z DOI: .
Go to original source...
Go to PubMed...
- Wang D, Yin Y, Hu C et al. Clinical course and outcome of 107 patients infected with the novel coronavirus, SARS‑CoV-2, discharged from two hospitals in Wuhan, China. Crit Care 2020; 24(1): 188. Dostupné z DOI: < https://doi.org/10.1186/s13054-020-02895-6>.
Go to original source...
Go to PubMed...
- Wang Z, Yang B, Li Q et al. Clinical Features of 69 Cases With Coronavirus Disease 2019 in Wuhan, China. Clin Infect Dis 2020; 71(15): 769-777. Dostupné z DOI: .
Go to original source...
Go to PubMed...
- He Y, Li W, Wang Z, et al. Nosocomial infection among patients with COVID-19: a retrospective data analysis of 918 cases from a single center in Wuhan, China. Infect Control Hosp Epidemiol 2020; 41(8): 982-983. Dostupné z DOI: .
Go to original source...
Go to PubMed...
- Huang C, Wang Y, Li X et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395(10223): 497-506. Dostupné z DOI: .
Go to original source...
Go to PubMed...
- Chen G, Wu D, Guo W et al. Clinical and immunological features of severe and moderate coronavirus disease 2019. J Clin Invest 2020; 130(5): 2620-2629. Dostupné z DOI: .
Go to original source...
Go to PubMed...
- Chen T, Wu D, Chen H et al. Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study. BMJ 2020; 368: m1295. Dostupné z DOI: .
Go to original source...
Go to PubMed...
- Chen H, Guo J, Wang C et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records Lancet 2020; 395 (10226): 809-815. Dostupné z DOI: .
Go to original source...
Go to PubMed...
- Xu XW, Wu XX, Jiang XG et al. Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS‑Cov-2) outside of Wuhan, China: retrospective case series. BMJ 2020; 368: m606. Dostupné z DOI: .
Go to original source...
Go to PubMed...
- Cao B, Wang Y, Wen D et al. A trial of Lopinavir-Ritonavir in adults hospitalized with severe Covid-19. N Engl J Med 2020; 382(19): 1787-1799. Dostupné z DOI: .
Go to original source...
- Zhao XY, Xu XX, Yin HS et al. Clinical characteristics of patients with 2019 coronavirus disease in a non‑Wuhan area of Hubei Province, China: a retrospective study. BMC Infect Dis 2020; 20(1): 311. Dostupné z DOI: .
Go to original source...
Go to PubMed...
- Borba MGS, Val FFA, Sampaio VS et al. Effect of high vs low doses of chloroquine diphosphate as adjunctive therapy for patients hospitalized with severe acute respiratory syndrome coronavirus 2 (SARS‑CoV-2) infection: a randomized clinical trial. JAMA Netw Open 2020; 3(4): e208857. Dostupné z DOI: .
Go to original source...
Go to PubMed...
- Pedersen HP, Hildebrandt T, Poulsen A, et al. Initial experiences from patients with COVID-19 on ventilatory support in Denmark. Dan Med J 2020; 67(5): A04200232. PMID: 32351196.
Go to PubMed...
- Aggarwal S, Garcia‑Telles N, Aggarwal G et al. Clinical features, laboratory characteristics, and outcomes of patients hospitalized with coronavirus disease 2019 (COVID-19): Early report from the United States. Diagnosis 2020; 7(2): 91-96. Dostupné z DOI: .
Go to original source...
Go to PubMed...
- Guan W, Ni Z, Hu Y et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med 2020; 382(18): 1708-1720. Dostupné z DOI: .
Go to original source...
Go to PubMed...
- Htoutou Sedláková M, Vojtová V, Hanulík V, et al. Rezistence enterobakterií k vybraným antibiotikům v souvislosti s jejich spotřebou. Klin Farmakol Farm 2012; 26(2): 61-66.
- Urbanek K, Kolar M, Loveckova Y et al. Influence of 3rd generation cephalosporin utilization on the occurrence of ESBL‑positive Klebsiella pneumoniae strains. J Clin Pharm Ther 2007; 32(4): 403-408. Dostupné z DOI: .
Go to original source...
Go to PubMed...
- Kolar M, Urbanek K, Latal T. Antibiotic selective pressure and development of bacterial resistance. Int J Antimicrob Agents 2001; 17(5): 357-363. Dostupné z DOI: .
Go to original source...
Go to PubMed...
- Kim HS. Do an altered gut microbiota and an associated leaky gut affect COVID-19 severity? mBio 2021; 12 (1): e03022-20. Dostupné z DOI: .
Go to original source...
Go to PubMed...
- Martin E, Philbin M, Hughes G et al. Antimicrobial stewardship challenges and innovative initiatives in the acute hospital setting during the COVID-19 pandemic. J Antimicrob Chemother 2021; 76(1): 272-275. Dostupné z DOI: .
Go to original source...
Go to PubMed...
- Sieswerda E, De Boer MGJ, Bonten MM et al. Recommendations for antibacterial therapy in adults with COVID-19 - An evidence based guideline. Clin Microbiol Infect 2021; 27(1): 61-66. Dostupné z DOI: .
Go to original source...
Go to PubMed...
- World Health Organization. COVID-19 Clinical management: living guidance. WHO. [cit. 2021-09-01]. Dostupné z WWW: .
- National Institute for Health and Care Excellence. COVID-19 rapid guideline: managing COVID-19. NICE. [cit. 2021-09-01]. Dostupné z WWW: .
- Cong W, Poudel AN, Alhusein N et al. Antimicrobial Use in COVID-19 Patients in the First Phase of the SARS‑CoV-2 Pandemic: A Scoping Review. Antibiotics 2021; 10(6): 745. Dostupné z DOI: .
Go to original source...
Go to PubMed...
- Liu C, Wen Y, Wan W et al. Clinical characteristics and antibiotics treatment in suspected bacterial infection patients with COVID-19. Int Immunopharmacol 2021; 90: 107157. Dostupné z DOI: .
Go to original source...
Go to PubMed...
- Kolář M. Respirační infekce a jejich léčba. Maxdorf: Praha 2016. ISBN 978-80-7345-481-4.
- Kolář M, Bardoň J, Rejman D. Zásady antibiotické léčby. VUP: Olomouc 2020. ISBN 978-80-244-5740-6.
Go to original source...
- Kolář M, Beneš J, Kolek V, et al. Klinický doporučený postup Nozokomiální pneumonie - antibiotická léčba. Národní portál klinických doporučených postupů [cit. 2021-09-01]. Dostupné z WWW: .
- Torres A, Niederman M, Chastre J et al. International ERS/ESICM/ESCMID/ALAT guidelines for the management of hospital‑acquired pneumonia and ventilator‑associated pneumonia. Eur Respir J 2017; 50(3): 1700582. Dostupné z DOI: .
Go to original source...
Go to PubMed...