COVID-19 Hospital Data Reveal Rush to Antibiotics

Coronavirus disease 2019 (COVID-19) can present with bacterial coinfection, but concerns about antibiotic over-prescription haven’t gone away amid the SARS-CoV-2 pandemic.

Soon after visiting 38 hospitals in Michigan, over half of patients hospitalized with suspected COVID-19 received antibiotics, according to authors of a new study in Clinical Infectious Diseases.

Patients were feared to have a bacterial coinfection alongside COVID-19.

But testing later showed that 96.5% of patients only had the coronavirus, making the antibiotic prescriptions superfluous.

Data were collected between 3/13/2020-6/18/2020.

Out of a total 1705 patients with COVID-19, 56.6% were prescribed early empiric antibacterial therapy. Only 3.5% (59/1705) had a confirmed community-onset bacterial infection.

Across the 38 hospitals, early empiric antibacterial use varied greatly from 27%-84%.

“Over time, COVID-19 test turnaround time (returned ≤1 day in March [54.2%, 461/850] vs. in April [85.2%, 628/737], P<.001) and empiric antibacterial use (ARR: 0.71 [0.63-0.81] April vs. March) decreased,” authors reported.

Despite a low prevalence of confirmed community-onset bacterial coinfection, half of patients received early empiric antibacterial therapy.

Antibiotic prescribing in reaction to the pandemic varied widely by hospital.

“Reducing COVID-19 test turnaround time and supporting stewardship could improve antibacterial use,” study authors concluded.

Continuing Antibiotic Stewardship in a Pandemic

Debbie Goff, PharmD, describes how antimicrobial stewardship work has continued during the COVID-19 pandemic.