tetano
Editor, Senior Moderator
Infection
. 2021 Oct 8.
doi: 10.1007/s15010-021-01699-2. Online ahead of print.
All-cause mortality and disease progression in SARS-CoV-2-infected patients with or without antibiotic therapy: an analysis of the LEOSS cohort
Maximilian J Schons[SUP] 1 [/SUP], Amke Caliebe[SUP] #[/SUP][SUP] 2 3 [/SUP], Christoph D Spinner[SUP] 4 [/SUP], Annika Y Classen[SUP] 1 5 [/SUP], Lisa Pilgram[SUP] 6 [/SUP], Maria M Ruethrich[SUP] 7 [/SUP], Jan Rupp[SUP] 8 [/SUP], Susana Nunes de Miranda[SUP] 1 [/SUP], Christoph Römmele[SUP] 9 [/SUP], Janne Vehreschild[SUP] 1 5 6 [/SUP], Bjoern-Erik Jensen[SUP] 10 [/SUP], Maria Vehreschild[SUP] 6 [/SUP], Christian Degenhardt[SUP] 11 [/SUP], Stefan Borgmann[SUP] 12 [/SUP], Martin Hower[SUP] 13 [/SUP], Frank Hanses[SUP] 14 [/SUP], Martina Haselberger[SUP] #[/SUP][SUP] 15 [/SUP], Anette K Friedrichs[SUP] 16 [/SUP], LEOSS-study group
Collaborators, Affiliations
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.
Keywords: Antibiotic stewardship; Antibiotics; COVID-19; LEOSS; Procalcitonin.
. 2021 Oct 8.
doi: 10.1007/s15010-021-01699-2. Online ahead of print.
All-cause mortality and disease progression in SARS-CoV-2-infected patients with or without antibiotic therapy: an analysis of the LEOSS cohort
Maximilian J Schons[SUP] 1 [/SUP], Amke Caliebe[SUP] #[/SUP][SUP] 2 3 [/SUP], Christoph D Spinner[SUP] 4 [/SUP], Annika Y Classen[SUP] 1 5 [/SUP], Lisa Pilgram[SUP] 6 [/SUP], Maria M Ruethrich[SUP] 7 [/SUP], Jan Rupp[SUP] 8 [/SUP], Susana Nunes de Miranda[SUP] 1 [/SUP], Christoph Römmele[SUP] 9 [/SUP], Janne Vehreschild[SUP] 1 5 6 [/SUP], Bjoern-Erik Jensen[SUP] 10 [/SUP], Maria Vehreschild[SUP] 6 [/SUP], Christian Degenhardt[SUP] 11 [/SUP], Stefan Borgmann[SUP] 12 [/SUP], Martin Hower[SUP] 13 [/SUP], Frank Hanses[SUP] 14 [/SUP], Martina Haselberger[SUP] #[/SUP][SUP] 15 [/SUP], Anette K Friedrichs[SUP] 16 [/SUP], LEOSS-study group
Collaborators, Affiliations
- PMID: 34625912
- DOI: 10.1007/s15010-021-01699-2
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.
Keywords: Antibiotic stewardship; Antibiotics; COVID-19; LEOSS; Procalcitonin.