Schons, Maximilian J. and Caliebe, Amke and Spinner, Christoph D. and Classen, Annika Y. and Pilgram, Lisa and Ruethrich, Maria M. and Rupp, Jan and de Miranda, Susana Nunes and Rommele, Christoph and Vehreschild, Janne and Jensen, Bjoern-Erik and Vehreschild, Maria and Degenhardt, Christian and Borgmann, Stefan and Hower, Martin and Hanses, Frank and Haselberger, Martina and Friedrichs, Anette K. (2022) All-cause mortality and disease progression in SARS-CoV-2-infected patients with or without antibiotic therapy: an analysis of the LEOSS cohort. INFECTION, 50 (2). pp. 423-436. ISSN 0300-8126, 1439-0973
Full text not available from this repository. (Request a copy)Abstract
Purpose Reported antibiotic use in coronavirus disease 2019 (COVID-19) is far higher than the actual rate of reported bacterial co- and superinfection. A better understanding of antibiotic therapy in COVID-19 is necessary. Methods 6457 SARS-CoV-2-infected cases, documented from March 18, 2020, until February 16, 2021, in the LEOSS cohort were analyzed. As primary endpoint, the correlation between any antibiotic treatment and all-cause mortality/progression to the next more advanced phase of disease was calculated for adult patients in the complicated phase of disease and procalcitonin (PCT) <= 0.5 ng/ml. The analysis took the confounders gender, age, and comorbidities into account. Results Three thousand, six hundred twenty-seven cases matched all inclusion criteria for analyses. For the primary endpoint, antibiotic treatment was not correlated with lower all-cause mortality or progression to the next more advanced (critical) phase (n = 996) (both p > 0.05). For the secondary endpoints, patients in the uncomplicated phase (n = 1195), regardless of PCT level, had no lower all-cause mortality and did not progress less to the next more advanced (complicated) phase when treated with antibiotics (p > 0.05). Patients in the complicated phase with PCT > 0.5 ng/ml and antibiotic treatment (n = 286) had a significantly increased all-cause mortality (p = 0.029) but no significantly different probability of progression to the critical phase (p > 0.05). Conclusion In this cohort, antibiotics in SARS-CoV-2-infected patients were not associated with positive effects on all-cause mortality or disease progression. Additional studies are needed. Advice of local antibiotic stewardship- (ABS-) teams and local educational campaigns should be sought to improve rational antibiotic use in COVID-19 patients.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | CHARLSON COMORBIDITY INDEX; COVID-19; PROCALCITONIN; PNEUMONIA; COVID-19; Antibiotics; Antibiotic stewardship; Procalcitonin; LEOSS |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Abteilung für Krankenhaushygiene und Infektiologie Medicine > Notfallambulanz |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 27 Sep 2022 07:24 |
| Last Modified: | 27 Sep 2022 07:24 |
| URI: | https://pred.uni-regensburg.de/id/eprint/48011 |
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