Purpose Reported antibiotic use in coronavirus disease 2019 (COVID-19) is far higher than the actual rate of reported bacterial co- and superinfection. A better understanding of antibiotic therapy in COVID-19 is necessary. Methods 6457 SARS-CoV-2-infected cases, documented from March 18, 2020, until February 16, 2021, in the LEOSS cohort were analyzed. As primary endpoint, the correlation between any antibiotic treatment and all-cause mortality/progression to the next more advanced phase of disease was calculated for adult patients in the complicated phase of disease and procalcitonin (PCT) ≤ 0.5 ng/ml. The analysis took the confounders gender, age, and comorbidities into account. Results Three thousand, six hundred twenty-seven cases matched all inclusion criteria for analyses. For the primary endpoint, antibiotic treatment was not correlated with lower all-cause mortality or progression to the next more advanced (critical) phase ( n = 996) (both p > 0.05). For the secondary endpoints, patients in the uncomplicated phase ( n = 1195), regardless of PCT level, had no lower all-cause mortality and did not progress less to the next more advanced (complicated) phase when treated with antibiotics ( p > 0.05). Patients in the complicated phase with PCT > 0.5 ng/ml and antibiotic treatment ( n = 286) had a significantly increased all-cause mortality ( p = 0.029) but no significantly different probability of progression to the critical phase ( p > 0.05). Conclusion In this cohort, antibiotics in SARS-CoV-2-infected patients were not associated with positive effects on all-cause mortality or disease progression. Additional studies are needed. Advice of local antibiotic stewardship- (ABS-) teams and local educational campaigns should be sought to improve rational antibiotic use in COVID-19 patients.
【저자키워드】 COVID-19, procalcitonin, Antibiotics, antibiotic stewardship, LEOSS, 【초록키워드】 coronavirus disease, Comorbidity, Gender, Local, progression, Probability, Disease progression, Cohort, Patient, age, correlation, disease, Critical, antibiotic use, COVID-19 patients, Bacterial, antibiotic, primary endpoint, Analysis, Antibiotic therapy, Antibiotic treatment, Secondary endpoints, all-cause mortality, inclusion criteria, positive, Effect, PCT, confounder, significantly increased, IMPROVE, Result, analyzed, significantly, reported, treated, calculated, less, had no, analyses, not correlated, SARS-CoV-2-infected patient, the primary endpoint, 【제목키워드】 Mortality, Disease progression, Cohort, antibiotic, Analysis, SARS-CoV-2-infected patient,