İrfan Şencan1, Yasemin Çağ2, Oğuz Karabay3, Behice Kurtaran4, Ertuğrul Güçlü3, Aziz Öğütlü3, Zehra Demirbaş5, Dilek Bulut6, Gülden Eser Karlıdağ7, Merve Sefa Sayar6, Ezgi Gizem Şibar1, Oya Özlem Eren Kutsoylu8, Gülnur Kul9, Serpil Erol10, Begüm Bektaş2, Tülay Ünver Ulusoy1, Semanur Kuzi11, Meltem Tasbakan12, Özge Yiğit11, Nurgül Ceran10, Ayşe Seza İnal4, Pınar Ergen2, Tansu Yamazhan12, Hanife Uzar13, Canan Ağalar14
1Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Dışkapı Yıldırım Beyazıt Health Practice and Research Center, İstanbul, Turkey
2Department of Infectious Diseases and Clinical Microbiology, İstanbul Medeniyet University Faculty of Medicine, İstanbul, Turkey
3Department of Infectious Diseases and Clinical Microbiology, Sakarya University Faculty of Medicine, Sakarya, Turkey
4Department of Infectious Diseases and Clinical Microbiology, Çukurova University, Adana, Turkey
5Department of Infectious Diseases and Clinical Microbiology, Elbistan State Hospital, Kahramanmaraş, Turkey
6Department of Infectious Diseases and Clinical Microbiology, Van Training and Research Hospital, Van, Turkey
7Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences Turkey, Elazığ City Hospital, Elazığ, Turkey
8Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences Turkey, Elazığ City Hospital, Elazığ, Turkey
9Department of Infectious Diseases and Clinical Microbiology, Dörtyol State Hospital, Hatay, Turkey
10Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences Turkey, Haydarpaşa Training and Research Hospital Health Practice and Research Center, İstanbul, Turkey
11Department of Infectious Diseases and Clinical Microbiology, Ünye State Hospital, Ordu, Turkey
12Department of Infectious Diseases and Clinical Microbiology, Ege University Faculty of Medicine, İzmir, Turkey
13Department of Infectious Diseases and Clinical Microbiology, Viranşehir State Hospital, Şanlıurfa, Turkey
14Department of Infectious Diseases and Clinical Microbiology, Fenerbahçe University, Medicana Ataşehir Hospital, İstanbul, Turkey
Abstract
Background: Broad-spectrum empirical antimicrobials are frequently prescribed for patients with coronavirus disease 2019 (COVID-19) despite the lack of evidence for bacterial coinfection.
Aims: We aimed to cross-sectionally determine the frequency of antibiotics use, type of antibiotics prescribed, and the factors influencing antibiotics use in hospitalized patients with COVID-19 confirmed by polymerase chain reaction.
Study Design: The study was a national, multicenter, retrospective, and single-day point prevalence study.
Methods: This was a national, multicenter, retrospective, and single-day point-prevalence study, conducted in the 24-h period between 00:00 and 24:00 on November 18, 2020, during the start of the second COVID-19 peak in Turkey.
Results: A total of 1500 patients hospitalized with a diagnosis of COVID-19 were included in the study. The mean age ± standard deviation of the patients was 65.0 ± 15.5, and 56.2% (n = 843) of these patients were men. Of these hospitalized patients, 11.9% (n = 178) were undergoing invasive mechanical ventilation or ECMO. It was observed that 1118 (74.5%) patients were receiving antibiotics, of which 416 (37.2%) were prescribed a combination of antibiotics. In total, 71.2% of the patients had neither a clinical diagnosis nor microbiological evidence for prescribing antibiotics. In the multivariate logistic regression analysis, hospitalization in a state hospital (p < 0.001), requiring any supplemental oxygen (p = 0.005), presence of moderate/diffuse lung involvement (p < 0.001), C-reactive protein > 10 ULT coefficient (p < 0.001), lymphocyte count < 800 (p = 0.007), and clinical diagnosis and/or confirmation by culture (p < 0.001) were found to be independent factors associated with increased antibiotic use.
Conclusion: The necessity of empirical antibiotics use in patients with COVID-19 should be reconsidered according to their clinical, imaging, and laboratory findings.
