Antibiotics use among the suspected and confirmed COVID-19 patients in an intensive care unit of a tertiary care hospital of Nepal - A registry based study
Keywords:
Antibiotics, COVID-19, Empirical antibiotics, Intensive care unit, Severe pneumoniaAbstract
Background: Use of antibiotics among patients admitted for COVID-19 is common despite low incidence of bacterial coinfection and superinfection. The present study aimed to find out the prevalence of antibiotics among both suspected and confirmed COVID-19 admitted to ICU of a tertiary care hospital of Nepal.
Methods: A retrospective observational study of patients who met the WHO’s case definition of suspected or probable or confirmed severe acute respiratory syndrome coronavirus (SARS-CoV-2) admitted at Grande International Hospital ICU from July 2020 to December 2021 were enrolled in the study. Data was extracted from the ICU registry. Descriptive and analytical statistical tools were used to describe the demographic variables and association among antibiotic use and predictor variables.
Results: Out of 1351 admissions,728 patients were included in our study. 564(77.4%) of total cases received at least one dose of antibiotics during ICU stay. 392(53.7%) received antibiotics for more than 48 hours. The commonly prescribed antibiotics were piperacillin-tazobactam (282, 38.7%) followed by azithromycin (n=279), meropenem (n=271). The antibiotic use was higher during the first wave with subsequent decline and incline thereafter. Patients’ clinical outcome(alive/dead) was significantly related with duration of ICU stay, cardiovascular support, duration of antibiotic days (p-value <0.001), and number of comorbidities (p-value 0.017). Patients’ course of antibiotics was significantly related with duration of ICU stay (p-value <0.001), and duration of antibiotics (days) (p-value <0.001).
Conclusion: Majority of patients admitted to ICU for COVID-19 were treated with antibiotics empirically on admission which decreased as evidence of non-bacterial infection became available. Furthermore, age, duration of ICU stays, cardiovascular support, duration of antibiotic days, and number of comorbidities have a significant impact on the clinical outcome of COVID-19 patients.
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