Valladales-Restrepo Luis Fernando, Delgado-Araujo Ana Camila, Echeverri-Martínez Luisa Fernanda, Sánchez-Ríos Verónica, Machado-Alba Jorge Enrique
Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira-Audifarma S.A., Pereira 660002, Colombia.
Grupo de Investigación Biomedicina, Facultad de Medicina, Fundación Universitaria Autónoma de las Américas, Pereira 660005, Colombia.
Antibiotics (Basel). 2023 Jan 26;12(2):252. doi: 10.3390/antibiotics12020252.
Antibiotics are frequently prescribed to patients with COVID-19. The aim was to determine the pattern of use of systemic antibiotics in a group of patients diagnosed with COVID-19 in Colombia between 2020-2022. This was a descriptive cross-sectional study designed to identify antibiotics prescription patterns for patients diagnosed with COVID-19 treated in eight clinics in Colombia. The AWaRe tool of the World Health Organization (WHO) was used to classify the antibiotics. A total of 10,916 patients were included. The median age was 57 years, and 56.4% were male. A total of 57.5% received antibiotics, especially ampicillin/sulbactam (58.8%) and clarithromycin (47.9%). Most of the antibiotics were classified as Watch (65.1%), followed by Access (32.6%) and Reserve (2.4%). Men (OR: 1.29; 95%CI: 1.17-1.43), older adults (OR: 1.67; 95%CI: 1.48-1.88), patients with dyspnea (OR: 1.26; 95%CI: 1.13-1.41), rheumatoid arthritis (OR: 1.94; 95%CI: 1.17-3.20), and high blood pressure at admission (OR: 1.45; 95%CI: 1.29-1.63), patients treated in-hospital (OR: 5.15; 95%CI: 4.59-5.77), patients admitted to the ICU (OR: 10.48; 95%CI: 8.82-12.45), patients treated with systemic glucocorticoids (OR: 3.60; 95%CI: 3.21-4.03) and vasopressors (OR: 2.10; 95%CI: 1.60-2.75), and patients who received invasive mechanical ventilation (OR: 2.37; 95%CI: 1.82-3.09) were more likely to receive a systemic antibiotic. Most of the patients diagnosed with COVID-19 received antibiotics, despite evidence showing that bacterial coinfection is rare. Antibiotics from the Watch group predominated, a practice that goes against WHO recommendations.
抗生素经常被开给新冠肺炎患者。目的是确定2020年至2022年期间哥伦比亚一组确诊为新冠肺炎的患者中全身用抗生素的使用模式。这是一项描述性横断面研究，旨在确定哥伦比亚八家诊所中确诊为新冠肺炎的患者的抗生素处方模式。使用世界卫生组织（WHO）的AWaRe工具对抗生素进行分类。共纳入10916名患者。中位年龄为57岁，男性占56.4%。共有57.5%的患者接受了抗生素治疗，尤其是氨苄西林/舒巴坦（58.8%）和克拉霉素（47.9%）。大多数抗生素被归类为“观察类”（65.1%），其次是“可及类”（32.6%）和“储备类”（2.4%）。男性（比值比：1.29；95%置信区间：1.17 - 1.43）、老年人（比值比：1.67；95%置信区间：1.48 - 1.88）、有呼吸困难的患者（比值比：1.26；95%置信区间：1.13 - 1.41）、类风湿性关节炎患者（比值比：1.94；95%置信区间：1.17 - 3.20）、入院时患有高血压的患者（比值比：1.45；95%置信区间：1.29 - 1.63）、在医院接受治疗的患者（比值比：5.15；95%置信区间：4.59 - 5.77）、入住重症监护病房的患者（比值比：10.48；95%置信区间：8.82 - 12.45）、接受全身糖皮质激素治疗的患者（比值比：3.60；95%置信区间：3.21 - 4.03）和血管加压药治疗的患者（比值比：2.10；95%置信区间：1.60 - 2.75）以及接受有创机械通气的患者（比值比：2.37；95%置信区间：1.82 - 3.09）更有可能接受全身用抗生素治疗。尽管有证据表明细菌合并感染很少见，但大多数确诊为新冠肺炎的患者接受了抗生素治疗。“观察类”组的抗生素占主导，这种做法与WHO的建议相悖。
