This scoping review provides new evidence on the prevalence and patterns of global antimicrobial use in the treatment of COVID-19 patients; identifies the most commonly used antibiotics and clinical scenarios associated with antibiotic prescribing in the first phase of the pandemic; and explores the impact of documented antibiotic prescribing on treatment outcomes in COVID-19 patients. The review complies with PRISMA guidelines for Scoping Reviews and the protocol is registered with the Open Science Framework. In the first six months of the pandemic, there was a similar mean antibiotic prescribing rate between patients with severe or critical illness (75.4%) and patients with mild or moderate illness (75.1%). The proportion of patients prescribed antibiotics without clinical justification was 51.5% vs. 41.9% for patients with mild or moderate illness and those with severe or critical illness. Comparison of patients who were provided antibiotics with a clinical justification with those who were given antibiotics without clinical justification showed lower mortality rates (9.5% vs. 13.1%), higher discharge rates (80.9% vs. 69.3%), and shorter length of hospital stay (9.3 days vs. 12.2 days). In the first 6 months of the pandemic, antibiotics were prescribed for COVID-19 patients regardless of severity of illness. A large proportion of antibiotic prescribing for mild and moderate COVID-19 patients did not have clinical evidence of a bacterial co-infection. Antibiotics may not be beneficial to COVID-19 patients without clinical evidence of a bacterial co-infection.
【저자키워드】 disease severity, antibiotic use, secondary infections, COVID-19 patients, clinical justification, 【초록키워드】 COVID-19, Treatment, review, Treatment outcome, pandemic, protocol, severity, Antibiotics, Moderate COVID-19, Prevalence, Patient, Mild, Critical, moderate, bacterial co-infection, Evidence, antibiotic, COVID-19 patient, Hospital stay, Registered, lower mortality, clinical evidence, discharge rate, Open Science Framework, identify, proportion, provided, provide, were given, 【제목키워드】 COVID-19, review, antimicrobial, phase, the SARS-CoV-2,