Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Dışkapı Yıldırım Beyazıt Health Practice and Research Center, İstanbul, Turkey
Department of Infectious Diseases and Clinical Microbiology, İstanbul Medeniyet University Faculty of Medicine, İstanbul, Turkey
Balkan Med J. 2022 May 24;39(3):209-217. doi: 10.4274/balkanmedj.galenos.2022.2021-11-62.
Broad-spectrum empirical antimicrobials are frequently prescribed for patients with coronavirus disease 2019 (COVID-19) despite the lack of evidence for bacterial coinfection.
We aimed to cross-sectionally determine the frequency of antibiotics use, type of antibiotics prescribed, and the factors influencing antibiotics use in hospitalized patients with COVID-19 confirmed by polymerase chain reaction.
The study was a national, multicenter, retrospective, and single-day point prevalence study.
This was a national, multicenter, retrospective, and single-day point-prevalence study, conducted in the 24-h period between 00:00 and 24:00 on November 18, 2020, during the start of the second COVID-19 peak in Turkey.
A total of 1500 patients hospitalized with a diagnosis of COVID-19 were included in the study. The mean age ± standard deviation of the patients was 65.0 ± 15.5, and 56.2% (n = 843) of these patients were men. Of these hospitalized patients, 11.9% (n = 178) were undergoing invasive mechanical ventilation or ECMO. It was observed that 1118 (74.5%) patients were receiving antibiotics, of which 416 (37.2%) were prescribed a combination of antibiotics. In total, 71.2% of the patients had neither a clinical diagnosis nor microbiological evidence for prescribing antibiotics. In the multivariate logistic regression analysis, hospitalization in a state hospital ( < 0.001), requiring any supplemental oxygen ( = 0.005), presence of moderate/diffuse lung involvement ( < 0.001), C-reactive protein > 10 ULT coefficient ( < 0.001), lymphocyte count < 800 ( = 0.007), and clinical diagnosis and/or confirmation by culture ( < 0.001) were found to be independent factors associated with increased antibiotic use.
The necessity of empirical antibiotics use in patients with COVID-19 should be reconsidered according to their clinical, imaging, and laboratory findings.
尽管缺乏细菌合并感染的证据，广谱经验性抗菌药物仍经常用于治疗 2019 年冠状病毒病（COVID-19）患者。
我们旨在通过聚合酶链反应（PCR）检测确定住院 COVID-19 患者中抗生素使用的频率、使用的抗生素类型以及影响抗生素使用的因素。
这是一项全国性、多中心、回顾性、单日时点患病率研究。
这是一项全国性、多中心、回顾性、单日时点患病率研究，于 2020 年 11 月 18 日 00:00 至 24:00 的 24 小时内进行，此时正值土耳其第二波 COVID-19 高峰开始。
共纳入 1500 例诊断为 COVID-19 的住院患者。患者的平均年龄±标准差为 65.0±15.5，其中 56.2%（n=843）为男性。这些住院患者中，11.9%（n=178）正在接受有创机械通气或 ECMO。结果显示，1118（74.5%）例患者正在接受抗生素治疗，其中 416（37.2%）例患者联合使用了抗生素。总的来说，71.2%的患者既没有临床诊断，也没有微生物学证据来开具抗生素。多变量逻辑回归分析显示，在州立医院住院（<0.001）、需要任何补充氧气（=0.005）、存在中度/弥漫性肺受累（<0.001）、C 反应蛋白>10 ULT 系数（<0.001）、淋巴细胞计数<800（=0.007）和临床诊断以及/或培养证实（<0.001）与抗生素使用增加有关。
根据患者的临床、影像学和实验室检查结果，应重新考虑 COVID-19 患者经验性使用抗生素的必要性。
