Early Antibiotic Intervention Not Beneficial for Severe COVID-19 Cases

Early application of antibiotic therapy was not shown to impact the mortality rate in coronavirus 2019 (COVID-19) patients admitted to the intensive care unit (ICU) at one community hospital in Switzerland.

Nicolo Buenetti, MD, Department of Infectious Diseases, Bern University Hospital, and a team of Swiss-based investigators reviewed the data from medical records and found no benefit in the mortality rates in patients taking antibiotics versus another group not on the aforementioned medication class.

Their findings appeared in a letter to the editor in Journal of Infection.

“Our preliminary results illustrate that early administered antibiotics do not appear to significantly impact mortality or delayed hospital-acquired infections in critically ill patients and call into question the utility of early treatment of a presumptive bacterial superinfection in COVID-19 patients,” the team wrote.

The retrospective study included 48 COVID-19 patients admitted to the ICU on who were intubated and previously admitted to a community hospital dedicated to COVID-19 care in southern Switzerland.

Of the 48 patients, 19 of them were administered antibiotics before their ICU admission due to suspected bacterial coinfection. In addition, the investigators reported the two patient groups had similar characteristics upon hospital admittance.

In looking at the mortality rates, they reported the two groups faced similar outcomes. In the group without antibiotics, there was a 24% mortality rate. And in the group treated with antibiotics a 26% rate was reported (P = .86).

The investigators found no statistical difference in the number of delayed healthcare-associated infections during patient ICU stays. In terms of infections, urinary tract infections (UTIs) were more frequently reported in the group that didn’t take the antibiotics, and candidemias was experienced more frequently in the antibiotic group.

The investigators acknowledged the need for bigger studies with greater populations in this area before adding any more conclusive findings. That said, they drew preliminary conclusion that early administered antibiotics do not apparently significantly impact mortality or delayed hospital-acquired infections in patients critically ill with COVID-19.

The findings also question the use of early treatment for presumptive bacterial superinfection among patients with the virus.

“Large multi-centric studies are urgently needed to investigate the impact of early antibiotics therapy on mortality, subsequent healthcare associated infections and ICU complications,” the investigators wrote.