Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Aug 2;10(8):935.
doi: 10.3390/antibiotics10080935.

Antibiotics Prescribing in Intensive Care Settings during the COVID-19 Era: A Systematic Review

Lubna I Abu-Rub  1 , Hana A Abdelrahman  1 , Al-Reem A Johar  2 , Hashim A Alhussain  1 , Hamad Abdel Hadi  3 , Nahla O Eltai  1
Affiliations
Review

Antibiotics Prescribing in Intensive Care Settings during the COVID-19 Era: A Systematic Review

Lubna I Abu-Rub et al. Antibiotics (Basel). .

Abstract

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 S. aureus 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.

Keywords: COVID-19; ICU; SARS-CoV-2; antibiotic; antibiotic prescription; bacterial co-infections.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the study’s design; the collection, analyses, interpretation of data; the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
PRISMA schematic selection process of the included studies at each stage of the screening process.
Figure 2
Figure 2
Percentage of associated underlying conditions reported based on 31 reviewed studies. Data on comorbidity were not specified among the seven included studies.
Figure 3
Figure 3
Percentage of reported bacterial species in ICU patients with COVID-19 from reviewed studies (n = 12/38). “Others” includes the organisms Morganella morgani, Mycoplasma pneumoniae, Moraxella catarrhalis, Stenotrophomonas, Burkholderia gladiol, Pneumococcus pneumoniae, and Legionella pneumophila.
See this image and copyright information in PMC

References

    1. Zhou F., Yu T., Du R., Fan G., Liu Y., Liu Z., Xiang J., Wang Y., Song B., Gu X., et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: A retrospective cohort study. Lancet. 2020;395:1054–1062. doi: 10.1016/S0140-6736(20)30566-3. - DOI - PMC - PubMed
    1. WHO Coronavirus (COVID-19) Dashboard WHO Coronavirus (COVID-19) Dashboard with Vaccination Data. [(accessed on 24 May 2021)]; Available online: https://covid19.who.int/
    1. Cong W., Poudel A.N., Alhusein N., Wang H., Yao G., Lambert H. Antimicrobial use in COVID-19 patients in the first phase of the SARS-CoV-2 pandemic: Rapid review and evidence synthesis. medRxiv. 2021 doi: 10.1101/2021.02.18.21251932. - DOI - PMC - PubMed
    1. Koeppen M., Rosenberger P., Magunia H. COVID-19 Related Cardiovascular Comorbidities and Complications in Critically Ill Patients: A Systematic Review and Meta-analysis. Clin. Med. Insights Circ. Respir. Pulm. Med. 2021;15:1179548421992327. doi: 10.1177/1179548421992327. - DOI - PMC - PubMed
    1. Langford B.J., So M., Raybardhan S., Leung V., Westwood D., MacFadden D.R., Soucy J.-P.R., Daneman N. Bacterial co-infection and secondary infection in patients with COVID-19: A living rapid review and meta-analysis. Clin. Microbiol. Infect. 2020;26:1622–1629. doi: 10.1016/j.cmi.2020.07.016. - DOI - PMC - PubMed

LinkOut - more resources