Many COVID-19 patients received unnecessary antibiotics, adding risk

A new study published in the journal Clinical Infectious Diseases explores faster testing and understanding of risk factors to prevent the overuse of antibiotics on COVID-19 patients.

Reportedly, more than half of suspected hospitalized patients in Michigan (during the state’s peak months) received antibiotic medication as soon as they arrived at the hospital. This was because it was already widely known that having a bacterial infection in combination with COVID-19 increased the likelihood of death.

However, on later testing, it was revealed that only about 3.5% of patients had both infections, while 96.5% of patients didn’t have a bacterial infection. Antibiotics in no way help fight COVID-19, while the overuse of antibiotics can cause harmful side effects.

The data used in the study comes from more than 38 hospitals, including 1,700 patients in a statewide effort called Mi-COVID19. This program was launched just a few weeks after the first confirmed case of COVID-19 was diagnosed on March 10. The program uses multiple quality improvement sponsored by Blue Cross Blue Shield of Michigan.

The study also found that there was great variation within the state regarding how antibiotics were administered. Some hospitals administered antibiotics to a quarter of suspected COVID-19 patients within the first two days, while in others, nearly all suspected COVID-19 patients received antibiotics.

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Dr. Valerie Vaughn, the study’s lead author, says that the usage of antibiotics reduced as time went on, and COVID-19 test result turnaround time shortened. However, by that time, there would have already been too many patients with unnecessary antibiotics in their system.

“For every patient who eventually tested positive for both SARS-Cov2 and a co-occurring bacterial infection that was present on their arrival, 20 other patients received antibiotics but turned out not to need them,” says Vaughn. “These data show the crucial importance of early and appropriate testing, with rapid turnaround, to ensure appropriate use of antibiotics and reduce unneeded harm.”

Once turnaround times improved, the quicker antibiotic administration was stopped. Eventually, patients getting back their COVID-19 test results within one day increased from 54% in March to 89% in May. Another major obstacle in bacterial infection tests was the requirement for health workers to examine a patient’s airways. This was because it was difficult to conduct that test without the risk of possibly transmitting COVID-19, leaving many patients without a respiratory tract examination.

“Since their SARS-Cov-2 infection explains their symptoms, we should all be more judicious with prescribing antibiotics unless we see signs of a bacterial infection,” says Vaughn. “We need better guidance to help clinicians figure out if the cause of a rapid decline in condition is due to cytokine storm or bacterial infection, and better antibiotic stewardship programs to support physicians in determining if they need to order antibiotics and if so, for how long and with what tests for bacterial infection.”

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Source: Medical Xpress

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