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. 2022 May 26;12(6):877.
doi: 10.3390/jpm12060877.

Antibiotic Prescription and In-Hospital Mortality in COVID-19: A Prospective Multicentre Cohort Study

Larisa Pinte  1   2   3 , Alexandr Ceasovschih  4   5 , Cristian-Mihail Niculae  1   6 , Laura Elena Stoichitoiu  1   2   3 , Razvan Adrian Ionescu  1   2   3 , Marius Ioan Balea  7 , Roxana Carmen Cernat  8   9 , Nicoleta Vlad  8   9 , Vlad Padureanu  10   11 , Adrian Purcarea  12 , Camelia Badea  1   2 , Adriana Hristea  1   3   6 , Laurenţiu Sorodoc  4   5 , Cristian Baicus  1   2   3
Affiliations

Antibiotic Prescription and In-Hospital Mortality in COVID-19: A Prospective Multicentre Cohort Study

Larisa Pinte et al. J Pers Med. .

Abstract

Background: Since the beginning of the COVID-19 pandemic, empiric antibiotics (ATBs) have been prescribed on a large scale in both in- and outpatients. We aimed to assess the impact of antibiotic treatment on the outcomes of hospitalised patients with moderate and severe coronavirus disease 2019 (COVID-19).

Methods: We conducted a prospective multicentre cohort study in six clinical hospitals, between January 2021 and May 2021.

Results: We included 553 hospitalised COVID-19 patients, of whom 58% (311/553) were prescribed antibiotics, while bacteriological tests were performed in 57% (178/311) of them. Death was the outcome in 48 patients-39 from the ATBs group and 9 from the non-ATBs group. The patients who received antibiotics during hospitalisation had a higher mortality (RR = 3.37, CI 95%: 1.7-6.8), and this association was stronger in the subgroup of patients without reasons for antimicrobial treatment (RR = 6.1, CI 95%: 1.9-19.1), while in the subgroup with reasons for antimicrobial therapy the association was not statistically significant (OR = 2.33, CI 95%: 0.76-7.17). After adjusting for the confounders, receiving antibiotics remained associated with a higher mortality only in the subgroup of patients without criteria for antibiotic prescription (OR = 10.3, CI 95%: 2-52).

Conclusions: In our study, antibiotic treatment did not decrease the risk of death in the patients with mild and severe COVID-19, but was associated with a higher risk of death in the subgroup of patients without reasons for it.

Keywords: COVID-19; SARS-CoV-2; antibacterial agents; antibiotics; cohort studies; hospital mortality; mortality; prospective studies.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The flow diagram of the study describing the methods: participants’ recruitment, inclusion, exclusion, and outcomes.
Figure 2
Figure 2
The Kaplan–Meier curves for the whole group (a) and subgroups (ATB and non-ATB) (b).
See this image and copyright information in PMC

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