- Pre-ICU-admission antibiotics do not appear to affect presumptive bacterial superinfection or mortality in patients with COVID-19.
- Large multicenter studies are needed.
Why this matters
- The paucity of data for bacterial coinfection in COVID-19 patients suggests that presumptive use of broad-spectrum antimicrobials may only contribute to antibiotic resistance while providing no real clinical benefit.
- 48 ICU patients, median age 66.5 (interquartile range [IQR], 60-71) years.
- 40% (19) received antibiotics before admission, most frequently amoxicillin/clavulanate (66%, 13).
- Patients receiving antibiotics were more frequently women (32% vs 17% without) and receiving coadministered antivirals (68% vs 48% without).
- Mortality rates were similar between groups (26% with antibiotics vs 24% without; P=.86).
- No difference seen in health care-associated infections (median infection number/patient: IQR, 1 [1-2] both; P=.98).
- Most common infections: urinary tract infection (10.5% with vs 27.6% without), candidemia (15.8% with vs 6.9% without).
- Retrospective analysis of the effect of early antibiotic therapy on mortality, delayed severe health care-associated infections in intubated patients with COVID-19, Switzerland.
- Funding: Swiss National Science Foundation.
- Small sample.