COVID-19 Hastalarında Olası İkincil Bakteriyel Pnömoni İçin Antibiyotik Kullanmanın Yoğun Bakıma Nakil Gerekliliğine Etkisi: Bir Retrospektif Kohort Çalışma.

Objective: We aimed to determine the frequency of antibiotics use for possible secondary bacterial pneumonia among hospitalized COVID-19 adults and its association with transfer to intensive care unit (ICU). Material and Method: Hospitalized COVID-19 adults of a tertiary hospital followed retrospectively from 10 March through 31 December 2020, for possible secondary bacterial pneumonia and their transfer to ICU (if any). Patients with bacterial infections other than pneumonia were excluded. Possible bacterial pneumonia was defined as imaging compatible with bacterial pneumonia, together with (at least one of) cough sputum, body temperature above 37°C, leukocyte count over 10000/µL and/or procalcitonin level over 0.16µg/L. Results: Of the 724 eligibles, nine patients with a bacterial infection other than pneumonia were excluded, leaving 715 for analyses. Over a median of 7 (IQR=6) days of follow-up, 462 (64.6%) of the patients received antibiotics, while 253(35.4%) did not. Thirty-three (7.1%) of the patients receiving antibiotics were transferred to ICU, compared to 26 (10.3%) out of those who did not receive antibiotics: the risk of ICU was 0.70 (95%CI=0.43–1.14). In logistic regression analysis, transfer to ICU was lower, yet not statistically significant, among antibiotic receivers (0.56; 95%CI=0.30–1.03), adjusting for age, gender, comorbidity, COVID-19 severity, use of favipiravir, azithromycin, and hydroxychloroquine. Conclusion: Antbiotic use did not statistically significantly affect transfer to ICU. Prospective cohorts are warranted for conclusive evidence to discard the potential for type 2 errors or ineffectiveness of ampiric treatment due to amtimicrobial resistance, and to further validate diagnostic criteria and appropriateness of ampiric regimens. [ABSTRACT FROM AUTHOR]