1. Characterization of antimicrobial use and co-infections among hospitalized patients with COVID-19: a prospective observational cohort study
- Author
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Tilman Lingscheid, Lena J. Lippert, David Hillus, Tassilo Kruis, Charlotte Thibeault, Elisa T. Helbig, Pinkus Tober-Lau, Frieder Pfäfflin, Holger Müller-Redetzky, Martin Witzenrath, Thomas Zoller, Alexander Uhrig, Bastian Opitz, Norbert Suttorp, Tobias S. Kramer, Leif E. Sander, Miriam S. Stegemann, and Florian Kurth
- Subjects
Microbiology (medical) ,Cross Infection ,Infectious Diseases ,Anti-Infective Agents ,Coinfection ,SARS-CoV-2 ,Humans ,COVID-19 ,General Medicine ,Hospital Mortality ,Prospective Studies ,COVID-19 Drug Treatment - Abstract
Purpose To investigate antimicrobial use and primary and nosocomial infections in hospitalized COVID-19 patients to provide data for guidance of antimicrobial therapy. Methods Prospective observational cohort study conducted at Charité–Universitätsmedizin Berlin, including patients hospitalized with SARS-CoV-2-infection between March and November 2020. Results 309 patients were included, 231 directly admitted and 78 transferred from other centres. Antimicrobial therapy was initiated in 62/231 (26.8%) of directly admitted and in 44/78 (56.4%) of transferred patients. The rate of microbiologically confirmed primary co-infections was 4.8% (11/231). Although elevated in most COVID-19 patients, C-reactive protein and procalcitonin levels were higher in patients with primary co-infections than in those without (median CRP 110 mg/l, IQR 51–222 vs. 36, IQR 11–101, respectively; p Conclusions Primary co-infections are rare, yet antimicrobial use was frequent, mostly based on clinical worsening and elevated inflammation markers without clear evidence for co-infection. More reliable diagnostic prospects may help to reduce overtreatment. Rates of nosocomial infections are substantial in severely ill patients on organ support and associated with worse patient outcome.
- Published
- 2022