According to experts, COVID-19 patients need clear guidelines to reduce the risk of drug resistance in order to use antibiotics.
Study in Lancet microorganisms The journal found that during the first wave of the pandemic, bacterial infections in hospitalized COVID patients were rare, but antibiotic use was common.
A research team led by the University of Glasgow said that antibiotics should be restricted, especially for newly admitted patients, until tests confirm a bacterial infection.
“Precious” antibiotics
Co-author Karam Semple, a professor of child health and outbreak medicine at the University of Liverpool, explained in a briefing hosted by the Science Media Center: That is very.
“We see that much more antibiotics are used than we want, and the most valuable antibiotics we want to save for serious bacterial infections are being used. I also see them. “
Dr. Antonia Ho, Senior Clinical Lecturer at the University of Glasgow, said: For infection in the next few years. “
Observational study
In this study, 48,902 patients admitted to 260 hospitals in England, Scotland, and Wales with COVID-19 from February 6 to June 8 were infected with bacteria, identified bacterial types, and antibacterial. The number of people prescribed the drug and the type of antibiotic prescribed were identified. 2020.
The median age of the patients was 74 years.
The timing of infection was recorded before or after admission. Microbial tests were recorded for 17.7% of patients.
When bacterial infections were detected in COVID-19 patients, 70.6% were secondary infections that were transmitted more than 2 days after the patient was hospitalized. Staphylococcus aureus and Haemophilus influenzae were the most common causes of respiratory coinfection, and Enterobacteriaceae and Staphylococcus aureus were the most common secondary infections. Respiratory tract infection..
Bloodstream infection In most cases the cause is E. coli And Staphylococcus aureus.
If data were available, 37% of patients were prescribed antibiotics prior to admission, and 85% were receiving one or more antibiotics at some point during hospitalization.
Widespread antibiotics such as carbapenems were frequently used, accounting for 3.8% of all prescriptions. In contrast, carbapenem-saving alternatives were used less frequently, accounting for 0.2% to 1.5% of all prescriptions.
Antibacterial stewardship
The authors of the study stated that antibiotic management interventions should be incorporated into the care of COVID patients, especially if the test ruled out a bacterial infection or if it was unlikely that a bacterial infection had occurred prior to admission.
Dr. Clark Russell, a clinical lecturer on infectious diseases at the University of Edinburgh, said, “I think there are concerns about antimicrobial use patterns, and I’m worried that it could lead to an increase in resistant strains in the future. . –I wrote a treatise.
He advocated a “more restrictive approach to use”, “microbiological samples should ideally be obtained before administering antimicrobial agents to humans”, “to a wide range of antimicrobial agents”. Routine escalation should be avoided, especially in critical care. “
Co-infection, secondary infection, and antibiotic use in patients admitted with COVID-19 during the first pandemic wave from the ISARIC WHO CCP-UK study: multicenter, prospective cohort study. Lancet microorganisms. DOI: https://doi.org/10.1016/S2666-5247 (21) 00090-2
