tetano
Editor, Senior Moderator
BMC Infect Dis
. 2022 Jun 10;22(1):532.
doi: 10.1186/s12879-022-07516-x.
Decreased survival in children inpatients with COVID-19 and antibiotic prescription
Efrén Murillo-Zamora[SUP] 1 2 [/SUP], Xóchitl Trujillo[SUP] 3 [/SUP], Miguel Huerta[SUP] 3 [/SUP], Mónica Ríos-Silva[SUP] 4 [/SUP], Agustin Lugo-Radillo[SUP] 5 [/SUP], Oliver Mendoza-Cano[SUP] 6 [/SUP]
Affiliations
Abstract
Background: The empirical prescription of antibiotics to inpatients with Coronavirus Disease 2019 (COVID-19) is frequent despite uncommon bacterial coinfections. Current knowledge of the effect of antibiotics on the survival of hospitalized children with COVID-19 is limited.
Objective: To characterize the survival experience of children with laboratory-positive COVID-19 in whom antibiotics were prescribed at hospital admission.
Methods: A retrospective cohort study was conducted in Mexico, with children hospitalized due to COVID-19 from March 2020 to December 2021. Data from 1601 patients were analyzed using the Kaplan-Meier method and the log-rank test. We computed hazard ratios (HR) and 95% confidence intervals (CI) to evaluate the effect of the analyzed exposures on disease outcomes.
Results: Antibiotics were prescribed to 13.2% ([Formula: see text] = 211) of enrolled children and a higher mortality rate [14.9 (95% CI 10.1-19.8) vs. 8.3 (95% CI 6.8-9.8)] per 1000 person-days, [Formula: see text] < 0.001) was found among them. At any given cut-off, survival functions were lower in antibiotic-positive inpatients ([Formula: see text] < 0.001). In the multiple model, antibiotic prescription was associated with a 50% increase in the risk of fatal outcome (HR = 1.50, 95% CI 1.01-2.22). A longer interval between illness onset and healthcare-seeking and pneumonia at hospital admission was associated with a poorer prognosis.
Conclusions: Our results suggest that antibiotic prescription in children hospitalized due to COVID-19 is associated with decreased survival. If later replicated, these findings highlight the need for rational antibiotics in these patients.
Keywords: Anti-bacterial agents; COVID-19; Child; Drug prescriptions; Fatal outcome; Hospitalized.
. 2022 Jun 10;22(1):532.
doi: 10.1186/s12879-022-07516-x.
Decreased survival in children inpatients with COVID-19 and antibiotic prescription
Efrén Murillo-Zamora[SUP] 1 2 [/SUP], Xóchitl Trujillo[SUP] 3 [/SUP], Miguel Huerta[SUP] 3 [/SUP], Mónica Ríos-Silva[SUP] 4 [/SUP], Agustin Lugo-Radillo[SUP] 5 [/SUP], Oliver Mendoza-Cano[SUP] 6 [/SUP]
Affiliations
- PMID: 35689192
- DOI: 10.1186/s12879-022-07516-x
Abstract
Background: The empirical prescription of antibiotics to inpatients with Coronavirus Disease 2019 (COVID-19) is frequent despite uncommon bacterial coinfections. Current knowledge of the effect of antibiotics on the survival of hospitalized children with COVID-19 is limited.
Objective: To characterize the survival experience of children with laboratory-positive COVID-19 in whom antibiotics were prescribed at hospital admission.
Methods: A retrospective cohort study was conducted in Mexico, with children hospitalized due to COVID-19 from March 2020 to December 2021. Data from 1601 patients were analyzed using the Kaplan-Meier method and the log-rank test. We computed hazard ratios (HR) and 95% confidence intervals (CI) to evaluate the effect of the analyzed exposures on disease outcomes.
Results: Antibiotics were prescribed to 13.2% ([Formula: see text] = 211) of enrolled children and a higher mortality rate [14.9 (95% CI 10.1-19.8) vs. 8.3 (95% CI 6.8-9.8)] per 1000 person-days, [Formula: see text] < 0.001) was found among them. At any given cut-off, survival functions were lower in antibiotic-positive inpatients ([Formula: see text] < 0.001). In the multiple model, antibiotic prescription was associated with a 50% increase in the risk of fatal outcome (HR = 1.50, 95% CI 1.01-2.22). A longer interval between illness onset and healthcare-seeking and pneumonia at hospital admission was associated with a poorer prognosis.
Conclusions: Our results suggest that antibiotic prescription in children hospitalized due to COVID-19 is associated with decreased survival. If later replicated, these findings highlight the need for rational antibiotics in these patients.
Keywords: Anti-bacterial agents; COVID-19; Child; Drug prescriptions; Fatal outcome; Hospitalized.