Rate of Antibiotic Use and Associated Risk Factors in COVID-19 Hospitalized Patients
Abstract
Background
Literature suggests that antibiotic prescribing in COVID-19 patients is high, despite low rates of confirmed bacterial infection. There are little data on what drives prescribing habits.
Objective
This study sought to determine antibiotic prescribing rates and risk factors for antibiotic prescribing in hospitalized patients. It was the first study to assess risk factors for receiving more than one course of antibiotics.
Methods
This was a retrospective, multi-center, observational study. Patients admitted from March 1, 2020 to May 31, 2020 and treated for PCR-confirmed COVID-19 were included. The primary endpoint was the rate of antibiotic use during hospitalization. Secondary endpoints included risk factors associated with antibiotic use, risk factors associated with receiving more than one antibiotic course, and rate of microbiologically confirmed infections.
Results
A total of 208 encounters (198 patients) were included in the final analysis. Eighty-three percent of patients received at least one course of antibiotics, despite low rates of microbiologically confirmed infection (12%). Almost one-third of patients (30%) received more than one course of antibiotics. Risk factors identified for both antibiotic prescribing and receiving more than one course of antibiotics were more serious illness, increased hospital length of stay, intensive care unit admission, mechanical ventilation, and acute respiratory distress syndrome.
Conclusion and relevance
There were high rates of antibiotic prescribing with low rates of bacterial co-infection. Many patients received more than one course of antibiotics during hospitalization. This study highlights the need for increased antibiotic stewardship practices in COVID-19 patients.
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