Factors Influencing the Prescription of Antibacterial Drugs in COVID-19 Patients: An Antibacterial Surveillance Study
Introduction: The empiric use of antibiotics in Coronavirus Disease-2019 (COVID-19) infection is not routinely recommended unless a secondary bacterial infection is suspected or confirmed. However, there have been reports of widespread antibiotic use in COVID-19 patients, despite a low rate...
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| Format: | Article |
| Language: | English |
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JCDR Research and Publications Private Limited
2023-08-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://jcdr.net/articles/PDF/18295/63619_CE[Ra1]_F[SK]_PF1(HB_JD_OM)_QC(KK_RDW_SHU)_PFA(HB_KM)_PN(KM).pdf |
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| author | Roopali kedar Somani Radhika Soanker MVS Subbalaxmi Padmaja Durga |
| author_facet | Roopali kedar Somani Radhika Soanker MVS Subbalaxmi Padmaja Durga |
| author_sort | Roopali kedar Somani |
| collection | DOAJ |
| description | Introduction: The empiric use of antibiotics in Coronavirus
Disease-2019 (COVID-19) infection is not routinely recommended
unless a secondary bacterial infection is suspected or confirmed.
However, there have been reports of widespread antibiotic use
in COVID-19 patients, despite a low rate of secondary bacterial
co-infection. Therefore, this study aims to understand the
factors influencing the empirical prescription of antibacterial
drugs in Reverse Transcriptase-Polymerase Chain Reaction
(RT-PCR) confirmed COVID-19 patients in Indian settings, as
the available data is sparse and conflicting.
Aim: To determine the factors associated with antibacterial
prescription in patients with proven COVID-19 infection at a
tertiary care hospital.
Materials and Methods: An antibacterial surveillance study
was conducted at Nizam's Institute of Medical Sciences,
Hyderabad, Telangana, India. The study duration was two
months, from September 2020 to October 2020. The study
included COVID-19 patients admitted to critical and non-critical
COVID-19 Care Units. Patient data, including demographics,
general and systemic examination details, biochemistry,
pathological and microbiological reports, and treatment details,
were collected using a specially designed form. Patients who
were prescribed antibacterial drugs (other than repurposed
antibacterial drugs for COVID-19 treatment) were considered
as cases, while the rest were classified as controls. The Hazard
Ratio (HR) for factors associated with antibacterial prescription
was estimated using Cox regression analysis with the Statistical
Package for Social Sciences (SPSS) version 20.0.
Results: The study included 200 patients, of whom 45 (22.5%)
received antibacterial drugs and were classified as cases,
while the remaining 155 (77.5%) received antibacterial drugs
and were classified as controls. The median age of cases and
controls was 59 and 46 years, respectively. Cox regression
analysis showed that procalcitonin >1 ng/mL (HR: 1.074,
95% Confidence Interval [CI]: 1.009-1.142, p-value=0.02) and
admission to the critical care unit were independent predictors
of antibacterial prescription. Additionally, high-dose steroid use
(>120 mg/day of Methylprednisolone [MPS]) was associated
with a 20% higher risk of antibacterial prescription, although
the values were statistically non-significant (HR: 1.203, 95% CI:
0.503-2.879, p=0.678).
Conclusion: Admission to critical care units and procalcitonin
levels >1 ng/mL were identified as independent predictors of
antibacterial prescription in COVID-19 patients. Compliance
with hospital-based standard treatment guidelines promotes
the rational use of antibacterial drugs.
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| first_indexed | 2024-03-12T02:02:22Z |
| format | Article |
| id | doaj.art-98d1e542118b46e69227e9a1ce51077e |
| institution | Directory Open Access Journal |
| issn | 0973-709X 2249-782X |
| language | English |
| last_indexed | 2024-03-12T02:02:22Z |
| publishDate | 2023-08-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-98d1e542118b46e69227e9a1ce51077e2023-09-07T10:59:51ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research0973-709X2249-782X2023-08-01178050910.7860/JCDR/2023/63619.18295Factors Influencing the Prescription of Antibacterial Drugs in COVID-19 Patients: An Antibacterial Surveillance StudyRoopali kedar Somani0Radhika Soanker1MVS Subbalaxmi2Padmaja Durga3Assistant Professor, Department of Clinical Pharmacology and Therapeutics, Nizam’s Institute of Medical Sciences, Hyderabad, Telangana, India.Additional Professor and Head, Department of Pharmacology and Therapeutics, All India Institute of Medical Sciences, Bibinagar, Hyderabad, IndiaAdditional Professor, Department of General Medicine, Nizam’s Institute of Medical Sciences, Hyderabad, Telangana, IndiaProfessor and Head, Department of Anaesthesiology and Intensive Care, Nizam’s Institute of Medical Sciences, Hyderabad, Telangana, India.Introduction: The empiric use of antibiotics in Coronavirus Disease-2019 (COVID-19) infection is not routinely recommended unless a secondary bacterial infection is suspected or confirmed. However, there have been reports of widespread antibiotic use in COVID-19 patients, despite a low rate of secondary bacterial co-infection. Therefore, this study aims to understand the factors influencing the empirical prescription of antibacterial drugs in Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR) confirmed COVID-19 patients in Indian settings, as the available data is sparse and conflicting. Aim: To determine the factors associated with antibacterial prescription in patients with proven COVID-19 infection at a tertiary care hospital. Materials and Methods: An antibacterial surveillance study was conducted at Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India. The study duration was two months, from September 2020 to October 2020. The study included COVID-19 patients admitted to critical and non-critical COVID-19 Care Units. Patient data, including demographics, general and systemic examination details, biochemistry, pathological and microbiological reports, and treatment details, were collected using a specially designed form. Patients who were prescribed antibacterial drugs (other than repurposed antibacterial drugs for COVID-19 treatment) were considered as cases, while the rest were classified as controls. The Hazard Ratio (HR) for factors associated with antibacterial prescription was estimated using Cox regression analysis with the Statistical Package for Social Sciences (SPSS) version 20.0. Results: The study included 200 patients, of whom 45 (22.5%) received antibacterial drugs and were classified as cases, while the remaining 155 (77.5%) received antibacterial drugs and were classified as controls. The median age of cases and controls was 59 and 46 years, respectively. Cox regression analysis showed that procalcitonin >1 ng/mL (HR: 1.074, 95% Confidence Interval [CI]: 1.009-1.142, p-value=0.02) and admission to the critical care unit were independent predictors of antibacterial prescription. Additionally, high-dose steroid use (>120 mg/day of Methylprednisolone [MPS]) was associated with a 20% higher risk of antibacterial prescription, although the values were statistically non-significant (HR: 1.203, 95% CI: 0.503-2.879, p=0.678). Conclusion: Admission to critical care units and procalcitonin levels >1 ng/mL were identified as independent predictors of antibacterial prescription in COVID-19 patients. Compliance with hospital-based standard treatment guidelines promotes the rational use of antibacterial drugs. https://jcdr.net/articles/PDF/18295/63619_CE[Ra1]_F[SK]_PF1(HB_JD_OM)_QC(KK_RDW_SHU)_PFA(HB_KM)_PN(KM).pdfantibiotic prescriptionantimicrobial stewardshipantimicrobial resistancecoronavirus disease-2019methylprednisoloneprocalcitoninsevere acute respiratory syndrome coronavirus-2 |
| spellingShingle | Roopali kedar Somani Radhika Soanker MVS Subbalaxmi Padmaja Durga Factors Influencing the Prescription of Antibacterial Drugs in COVID-19 Patients: An Antibacterial Surveillance Study Journal of Clinical and Diagnostic Research antibiotic prescription antimicrobial stewardship antimicrobial resistance coronavirus disease-2019 methylprednisolone procalcitonin severe acute respiratory syndrome coronavirus-2 |
| title | Factors Influencing the Prescription of Antibacterial Drugs in COVID-19 Patients: An Antibacterial Surveillance Study |
| title_full | Factors Influencing the Prescription of Antibacterial Drugs in COVID-19 Patients: An Antibacterial Surveillance Study |
| title_fullStr | Factors Influencing the Prescription of Antibacterial Drugs in COVID-19 Patients: An Antibacterial Surveillance Study |
| title_full_unstemmed | Factors Influencing the Prescription of Antibacterial Drugs in COVID-19 Patients: An Antibacterial Surveillance Study |
| title_short | Factors Influencing the Prescription of Antibacterial Drugs in COVID-19 Patients: An Antibacterial Surveillance Study |
| title_sort | factors influencing the prescription of antibacterial drugs in covid 19 patients an antibacterial surveillance study |
| topic | antibiotic prescription antimicrobial stewardship antimicrobial resistance coronavirus disease-2019 methylprednisolone procalcitonin severe acute respiratory syndrome coronavirus-2 |
| url | https://jcdr.net/articles/PDF/18295/63619_CE[Ra1]_F[SK]_PF1(HB_JD_OM)_QC(KK_RDW_SHU)_PFA(HB_KM)_PN(KM).pdf |
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