[Guidelines for managing antibiotic therapy for bacterial community- and hospital-acquired pneumonia in patients with critical COVID-19]

Abstract

Bacterial pneumonia in critically ill patients with COVID-19 pose a significant healthcare concern. The critical stage of COVID-19 encompasses patients who are experiencing acute respiratory failure (ARDS), septic shock, and multiorgan failure. Data from the University Hospital Olomouc indicates that the incidence of bacterial Community-Acquired Pneumonia (CAP) and Hospital-Acquired Pneumonia (HAP) in critically ill patients with COVID-19 can reach up to 27% and 46%, respectively. These patients with bacterial CAP and HAP have higher mortality rates (38% and 56%, respectively) compared to critical COVID-19 patients without bacterial infection (11%). Given the severity of these patients' conditions, concerns regarding delayed initiation of antibiotic therapy are justified, as it could result in the development or progression of sepsis and increased mortality. On the other hand, unnecessary antibiotic treatment leads to adverse effects, dysbiosis, increased risk of secondary bacterial infections, development of antimicrobial resistance, and ultimately increased mortality. The provided guidelines offer a comprehensive framework of strategies for the diagnosis and treatment of bacterial pneumonia in patients with critical-stage COVID-19.