Milmedika

Following the acute phase of the illness, along with the development of various "post-acute" and "long COVID" conditions, a significant number of patients report symptoms that may be linked to the side effects of antibiotics. We present the results of an analysis (adjusted for the general population) that reminds us of the importance of rational antibiotic use and warns of the consequences of their misuse.

Antibiotics and COVID-19

Antimicrobial resistance raises serious concerns due to the increased use of antibiotics in patients infected with the SARS-CoV-2 virus. Although COVID-19 is a viral illness, studies show that antibiotics are often prescribed due to suspicion of bacterial co-infections.

Meta-analysis results

• The analysis included 30,623 patients.
• 62.4% of patients (19,102) received at least one antibiotic.
• The prevalence of bacterial co-infection in hospitalized patients was 3.5%, while the prevalence of secondary infections was 14.3%.
• 74.6% of patients received antibiotic therapy, which is 10 times higher than the estimated prevalence of bacterial co-infection (6.1%-8.0%).

Risks of overuse of antibiotics

Given the low prevalence of bacterial co-infection in patients with COVID-19, excessive use of antibiotics carries significant risks:

• Increased risk of adverse events
• Increased risk of Clostridium difficile infection
• Development of antimicrobial resistance, which makes treating future infections more difficult

Conclusions and recommendations

The results of the analysis highlight:

• The importance of rational and targeted antibiotic use
• The urgency of efforts to reduce excessive antibiotic use during the treatment of COVID-19
• The need for clear protocols to ensure patients receive the maximum benefit from antibiotic therapy while minimizing risks

Source:

Langford BJ, So M, Raybardhan S, et al. Antibiotic prescribing in patients with COVID-19: rapid review and meta-analysis. Clin Microbiol Infect. 2021;27(4):520-531.