Antibiotic overuse for COVID-19; are we adding insult to injury?

Seid Getahun Abdela, Laurens Liesenborghs, Fentaw Tadese, Seid Hassen Abegaz, Fentaw Bialfew Bayuh, Etsegenet Arega Asmamaw, Tamiru Asefa Mebratie, Abreham Eshetu Mamo, Maraki Assefa Mebrate, Wendemaegn Embiale, Samuel Hunegnaw, Dereje Bedanie Hundie, Zewdu Hurissa, Gebi Agero, Abdene Weya Kaso, Saskia van Henten, Johan van Griensven

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In this study, we described the proportion of COVID-19 patients started on antibiotics empirically and the work-ups performed to diagnose bacterial superinfection. We used a retrospective cohort study design involving medical records of symptomatic, hospitalized COVID-19 patients who were admitted to these centers. A total of 481 patients were included, with a median age of 41.0 years (interquartile range, 28-58.5 years). A total of 72.1% (N = 347) of COVID-19 patients received antibiotics, either before or during admission. This is troublesome because none of the patients' bacterial culture or inflammatory markers, such as the erythrocyte sedimentation rate or C-reactive protein, were evaluated, and only 73 (15.2%) underwent radiological investigations. Therefore, national COVID-19 guidelines should emphasize the rational use of antibiotics for the treatment of COVID-19, a primarily viral disease. Integrating antimicrobial stewardship into the COVID-19 response and expanding microbiological capacities in low-income countries are indispensable. Otherwise, we risk one pandemic aggravating another.

Original languageEnglish
JournalAmerican Journal of Tropical Medicine and Hygiene
Publication statusE-pub ahead of print - 2021

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