Predictors and patterns of empirical antibiotic therapy and associated outcomes in COVID-19 patients: a retrospective study in a tertiary care facility in South India

Lipin Lukose, Gursimran Kaur, M. Mohammed Asif, Gail Ann Abraham, Kanav Khera, Viswam K. Subeesh, Ronald L. Castelino, Shubhada Karanth, Chandrashekar Udyavara Kudru, Muralidhar Varma, Sonal Sekhar Miraj

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The coronavirus disease (COVID-19) led to a global health crisis. Inappropriate use of antibiotics in COVID-19 patients has been a concern, leading to antimicrobial resistance. This study evaluated the patterns and predictors of empirical antibiotic therapy in COVID-19 patients and associated outcomes. Methods: A hospital-based retrospective study was conducted with 525 patients admitted to Kasturba Hospital, Manipal, India, with moderate and severe COVID-19 from 1 March to 1 August 2021. They were divided based on empirical therapy, and predictors of antibiotic usage were assessed by logistic regression. Results: Four hundred and eighty (91.4%) COVID-19 patients received at least one course of antibiotics, with 440 (83.8%) initiating empirical therapy. Patients with severe COVID-19 manifestations were more likely to be prescribed empirical antibiotics. Multivariable analysis showed that patients initiated on empirical antibiotics had significantly elevated levels of procalcitonin [OR: 3.91 (95% CI: 1.66–9.16) (p = 0.001)], invasive ventilation [OR: 3.93 (95% CI: 1.70–9.09) (p = 0.001)], shortness of breath [OR: 2.25 (95% CI: 1.30–3.89) (p = 0.003)] and higher CRP levels [OR: 1.01 (95% CI: 1.00–1.01) (p = 0.005)]. Most antibiotics (65.9%) were prescribed from the ‘Watch’ group, the highest being ceftriaxone. Only 23.8% of the patients had microbiologically confirmed infections. Conclusion: The study identified predictors for initiating empirical antibacterial therapy in our setting.

Original languageEnglish
Pages (from-to)333-341
Number of pages9
JournalExpert Review of Anti-Infective Therapy
Volume22
Issue number5
DOIs
Publication statusPublished - 2024

All Science Journal Classification (ASJC) codes

  • Microbiology
  • Microbiology (medical)
  • Infectious Diseases
  • Virology

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