Abu-Rub Lubna I, Abdelrahman Hana A, Johar Al-Reem A, Alhussain Hashim A, Hadi Hamad Abdel, Eltai Nahla O
Biomedical Research Center, Qatar University, Doha 2713, Qatar.
Barzan Holdings, Doha 7178, Qatar.
Antibiotics (Basel). 2021 Aug 2;10(8):935. doi: 10.3390/antibiotics10080935.
The prevalence of patients admitted to intensive care units (ICUs) with SARS-CoV-2 infection who were prescribed antibiotics is undetermined and might contribute to the increased global antibiotic resistance. This systematic review evaluates the prevalence of antibiotic prescribing in patients admitted to ICUs with SARS-CoV-2 infection using PRISMA guidelines. We searched and scrutinized results from PubMed and ScienceDirect databases for published literature restricted to the English language up to 11 May 2021. In addition, we included observational studies of humans with laboratory-confirmed SARS-CoV-2 infection, clinical characteristics, and antibiotics prescribed for ICU patients with SARS-CoV-2 infections. A total of 361 studies were identified, but only 38 were included in the final analysis. Antibiotic prescribing data were available from 2715 patients, of which prevalence of 71% was reported in old age patients with a mean age of 62.7 years. From the reported studies, third generation cephalosporin had the highest frequency amongst reviewed studies (36.8%) followed by azithromycin (34.2%). The estimated bacterial infection in 12 reported studies was 30.8% produced by 15 different bacterial species, and recorded the highest bacterial infection (75%). The fundamental outcomes were the prevalence of ICU COVID-19 patients prescribed antibiotics stratified by age, type of antibiotics prescribed, and the presence of co-infections and comorbidities. In conclusion, more than half of ICU patients with SARS-CoV-2 infection received antibiotics, and prescribing is significantly higher than the estimated frequency of identified bacterial co-infection.
入住重症监护病房（ICU）且感染了新型冠状病毒2（SARS-CoV-2）并接受抗生素治疗的患者的患病率尚不确定，这可能会加剧全球抗生素耐药性问题。本系统评价采用PRISMA指南评估入住ICU且感染SARS-CoV-2的患者中抗生素处方的患病率。我们检索并仔细审查了截至2021年5月11日PubMed和ScienceDirect数据库中仅限于英文发表的文献结果。此外，我们纳入了对实验室确诊的SARS-CoV-2感染患者、临床特征以及为感染SARS-CoV-2的ICU患者开具的抗生素的观察性研究。共识别出361项研究，但最终分析仅纳入了38项。有2715例患者的抗生素处方数据，其中平均年龄为62.7岁的老年患者中报告的患病率为71%。在所报告的研究中，第三代头孢菌素在审查研究中的使用频率最高（36.8%），其次是阿奇霉素（34.2%）。在12项报告的研究中，估计的细菌感染率为30.8%，由15种不同细菌引起，其中记录的最高细菌感染率为75%。主要结果是按年龄、所开抗生素类型以及合并感染和合并症情况分层的感染SARS-CoV-2的ICU患者中开具抗生素的患病率。总之，超过一半的感染SARS-CoV-2的ICU患者接受了抗生素治疗，且处方率显著高于已确定的细菌合并感染的估计发生率。
