Antibiotic administration prevalent in COVID-19 patients with no bacterial infection: Study

The COVID-19 pandemic has resulted in the rampant use of antibiotics in the diseased patients to treat bacterial co-infections or rule out the possibility of secondary infections

By Divya Khatter
Published: Monday 03 August 2020

Bacterial co-infections are relatively low in patients hospitalised with novel coronavirus disease (COVID-19), a recent study by a group of researchers in Canada has revealed.

Moreover, the patients who receive antibiotics for treatment of bacterial infections far outnumber the ones who actually need it, the study has added.

The findings, published in Clinical Microbiology and Infection, encompassed a meta-analysis of 28 studies representing a total of 3,848 patients.

The studies chosen for meta-analysis involved patients with laboratory confirmed SARS-CoV-2 infection, across all healthcare settings and age groups. The studies were done between December 2019 and March 2020 and the majority took place in Asia.

The researchers claim this to be the first living meta-analysis and systematic review focusing on bacterial co-infections in patients hospitalised for COVID-19.

The scientists observed that 3,448 patients were evaluated for acute bacterial infections which included cases of either co-infection ie infections existing on presentation, or secondary infection ie those contracted during the course of illness.

Bacterial isolates only from the respiratory tract and blood culture samples were included. The scientists further classified bacterial infection rates by patient population — in all hospitalized patients, critically ill patients (those admitted to intensive care unit), fatal cases — as an estimate of severity of COVID-19 illness.

The meta-analysis identified that of the evaluated patients, 3.5 per cent patients had co-infections and 15.5 per cent had secondary bacterial infections. The proportion of COVID-19 patients with bacterial infections turned out to be 7.1 per cent.

A classification on the basis of patient population yielded that bacterial infection ranged from 5.8 per cent in all hospitalised patients to 8.1 per cent in critically-ill patients (those admitted in intensive care units) and 11.6 per cent in fatal cases.

The common bacterial pathogens reported by the studies included Mycoplasma, Haemophilus influenzae and Pseudomonas aeruginosa.

The 18 studies reporting antibiotic administration to patients showed that about 71 per cent of the patients received antibiotic treatment. The administered antibiotics were broad-spectrum, with the majority belonging to the fluoroquinolone and carbapenem classes.

Bacterial co-infections are known to be responsible for increased morbidity and mortality in viral respiratory infections. However, their prevalence in COVID-19 patients is not well understood.

Moreover, studies have indicated the inefficacy of the use of antibiotics in COVID-19 patients. Despite this, the COVID-19 pandemic has resulted in the rampant use of antibiotics in the diseased patients to treat bacterial co-infections or rule out the possibility of secondary infections.

It is a huge concern in view of the growing antimicrobial resistance (AMR), a global public health threat. It further calls for an urgent need to resort to judicious antibiotic use even in these desperate COVID-19 times.

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