Epidemiological Impact on Use of Antibiotics in Patients Hospitalized for COVID-19: A Retrospective Cohort Study in Italy
The increased incidence of antimicrobial resistance during coronavirus disease 2019 (COVID-19) is a very important collateral damage of global concern. The cause is multifactorial and is particularly related to the high rates of antibiotic use in COVID-19 patients with a relatively low rate of secon...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-05-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/12/5/912 |
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| author | Zaira Maraia Tony Mazzoni Miriana Pia Turtora Alessandra Tempera Marco Spinosi Anita Vagnoni Isidoro Mazzoni |
| author_facet | Zaira Maraia Tony Mazzoni Miriana Pia Turtora Alessandra Tempera Marco Spinosi Anita Vagnoni Isidoro Mazzoni |
| author_sort | Zaira Maraia |
| collection | DOAJ |
| description | The increased incidence of antimicrobial resistance during coronavirus disease 2019 (COVID-19) is a very important collateral damage of global concern. The cause is multifactorial and is particularly related to the high rates of antibiotic use in COVID-19 patients with a relatively low rate of secondary co-infection. To this end, we conducted a retrospective observational study of 1269 COVID-19 patients admitted during the years 2020, 2021 and 2022 in two Italian hospitals, with a focus on bacterial co-infections and antimicrobial therapy. Multivariate logistic regression was used to analyze the association between bacterial co-infection, antibiotic use and hospital death after adjustment for age and comorbidity. Bacterial co-infection was detected in 185 patients. The overall mortality rate was 25% (<i>n</i> = 317). Concomitant bacterial infections were associated with increased hospital mortality (β = 1.002, <i>p</i> < 0.001). A total of 83.7% (<i>n</i> = 1062) of patients received antibiotic therapy, but only 14.6% of these patients had an obvious source of bacterial infection. There was a significantly higher rate of hospital mortality in patients who received antibiotics than in those who did not (χ<sup>2</sup> = 6.22, <i>p</i> = 0.012). Appropriate prescribing and the rational use of antimicrobials according to the principles of antimicrobial stewardship can help prevent the emergence of antibiotic resistance. |
| first_indexed | 2024-03-11T03:59:30Z |
| format | Article |
| id | doaj.art-4f1b82e4c2624ab791f4620bf84dc34b |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-11T03:59:30Z |
| publishDate | 2023-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-4f1b82e4c2624ab791f4620bf84dc34b2023-11-18T00:13:10ZengMDPI AGAntibiotics2079-63822023-05-0112591210.3390/antibiotics12050912Epidemiological Impact on Use of Antibiotics in Patients Hospitalized for COVID-19: A Retrospective Cohort Study in ItalyZaira Maraia0Tony Mazzoni1Miriana Pia Turtora2Alessandra Tempera3Marco Spinosi4Anita Vagnoni5Isidoro Mazzoni6School of Specialization in Clinical Pharmacology and Toxicology, University of L’Aquila, 67100 L’Aquila, ItalySchool of Specialization in Hospital Pharmacy, University of Camerino, 62032 Camerino, ItalySchool of Specialization in Hospital Pharmacy, University of Camerino, 62032 Camerino, ItalySchool of Specialization in Hospital Pharmacy, University of Camerino, 62032 Camerino, ItalyAscoli Piceno Hospital Pharmacy, 63100 Ascoli Piceno, ItalyAscoli Piceno Hospital Pharmacy, 63100 Ascoli Piceno, ItalyAscoli Piceno Hospital Pharmacy, 63100 Ascoli Piceno, ItalyThe increased incidence of antimicrobial resistance during coronavirus disease 2019 (COVID-19) is a very important collateral damage of global concern. The cause is multifactorial and is particularly related to the high rates of antibiotic use in COVID-19 patients with a relatively low rate of secondary co-infection. To this end, we conducted a retrospective observational study of 1269 COVID-19 patients admitted during the years 2020, 2021 and 2022 in two Italian hospitals, with a focus on bacterial co-infections and antimicrobial therapy. Multivariate logistic regression was used to analyze the association between bacterial co-infection, antibiotic use and hospital death after adjustment for age and comorbidity. Bacterial co-infection was detected in 185 patients. The overall mortality rate was 25% (<i>n</i> = 317). Concomitant bacterial infections were associated with increased hospital mortality (β = 1.002, <i>p</i> < 0.001). A total of 83.7% (<i>n</i> = 1062) of patients received antibiotic therapy, but only 14.6% of these patients had an obvious source of bacterial infection. There was a significantly higher rate of hospital mortality in patients who received antibiotics than in those who did not (χ<sup>2</sup> = 6.22, <i>p</i> = 0.012). Appropriate prescribing and the rational use of antimicrobials according to the principles of antimicrobial stewardship can help prevent the emergence of antibiotic resistance.https://www.mdpi.com/2079-6382/12/5/912antibiotic usecoinfectionspandemicsSARS-CoV-2 |
| spellingShingle | Zaira Maraia Tony Mazzoni Miriana Pia Turtora Alessandra Tempera Marco Spinosi Anita Vagnoni Isidoro Mazzoni Epidemiological Impact on Use of Antibiotics in Patients Hospitalized for COVID-19: A Retrospective Cohort Study in Italy Antibiotics antibiotic use coinfections pandemics SARS-CoV-2 |
| title | Epidemiological Impact on Use of Antibiotics in Patients Hospitalized for COVID-19: A Retrospective Cohort Study in Italy |
| title_full | Epidemiological Impact on Use of Antibiotics in Patients Hospitalized for COVID-19: A Retrospective Cohort Study in Italy |
| title_fullStr | Epidemiological Impact on Use of Antibiotics in Patients Hospitalized for COVID-19: A Retrospective Cohort Study in Italy |
| title_full_unstemmed | Epidemiological Impact on Use of Antibiotics in Patients Hospitalized for COVID-19: A Retrospective Cohort Study in Italy |
| title_short | Epidemiological Impact on Use of Antibiotics in Patients Hospitalized for COVID-19: A Retrospective Cohort Study in Italy |
| title_sort | epidemiological impact on use of antibiotics in patients hospitalized for covid 19 a retrospective cohort study in italy |
| topic | antibiotic use coinfections pandemics SARS-CoV-2 |
| url | https://www.mdpi.com/2079-6382/12/5/912 |
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