The effect of antibiotic prescription in non-critically ill hospitalized patients with COVID-19: A Japanese inpatient database study.
<h4>Background</h4>Coronavirus disease 2019 (COVID-19) is an ongoing global pandemic. Bacterial coinfections with COVID-19 occur in 3.5% of COVID-19 cases, with a higher incidence in severe cases. Although antibiotics have been prescribed to treat non-critically ill patients with COVID-1...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2025-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0318803 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850151620205084672 |
|---|---|
| author | Haruka Imai Jun Suzuki Tomoki Mizuno Shota Takahashi Hideya Itagaki Makiko Yoshida Shiro Endo Eiichi N Kodama |
| author_facet | Haruka Imai Jun Suzuki Tomoki Mizuno Shota Takahashi Hideya Itagaki Makiko Yoshida Shiro Endo Eiichi N Kodama |
| author_sort | Haruka Imai |
| collection | DOAJ |
| description | <h4>Background</h4>Coronavirus disease 2019 (COVID-19) is an ongoing global pandemic. Bacterial coinfections with COVID-19 occur in 3.5% of COVID-19 cases, with a higher incidence in severe cases. Although antibiotics have been prescribed to treat non-critically ill patients with COVID-19, their effect on non-critically ill hospitalized patients with COVID-19 remains uncertain.<h4>Methods</h4>We analyzed data from non-critically ill hospitalized patients with COVID-19 who were older than 18 years between January 1, 2020, and May 31, 2023. We performed propensity score matching analysis, evaluating in-hospital mortality with or without antibiotic prescription within 2 days of admission. Sensitivity analyses using inverse probability weighting and generalized estimating equation were also performed.<h4>Results</h4>Eligible patients (n = 144,110) were divided into antibiotic prescription (n = 3,873) and control (n = 140,237) groups. One-to-one propensity score matching identified 3,861 pairs of patients who received antibiotic prescriptions within 2 days of admission. Following this, antibiotic prescription was associated with a decreased 28-day mortality rate (2.3% vs. 3.6%) and in-hospital mortality rate (4.0% vs. 5.0%) compared with the control group. Conversely, antibiotics increased Clostridioides difficile infection (CDI) compared with the control group (0.6% vs. 0.1%). No statistical differences were observed between both groups regarding acute kidney injury (0.4% vs. 0.2%). Sensitivity analysis showed similar outcomes.<h4>Conclusions</h4>This multicenter observational study in Japan showed that antibiotic prescriptions were associated with lower 28-day and in-hospital mortalities and an increased CDI risk in non-critically ill hospitalized patients with COVID-19. |
| format | Article |
| id | doaj-art-2143fcf93dac47f58ac60f9391255e29 |
| institution | OA Journals |
| issn | 1932-6203 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-2143fcf93dac47f58ac60f9391255e292025-08-20T02:26:10ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01203e031880310.1371/journal.pone.0318803The effect of antibiotic prescription in non-critically ill hospitalized patients with COVID-19: A Japanese inpatient database study.Haruka ImaiJun SuzukiTomoki MizunoShota TakahashiHideya ItagakiMakiko YoshidaShiro EndoEiichi N Kodama<h4>Background</h4>Coronavirus disease 2019 (COVID-19) is an ongoing global pandemic. Bacterial coinfections with COVID-19 occur in 3.5% of COVID-19 cases, with a higher incidence in severe cases. Although antibiotics have been prescribed to treat non-critically ill patients with COVID-19, their effect on non-critically ill hospitalized patients with COVID-19 remains uncertain.<h4>Methods</h4>We analyzed data from non-critically ill hospitalized patients with COVID-19 who were older than 18 years between January 1, 2020, and May 31, 2023. We performed propensity score matching analysis, evaluating in-hospital mortality with or without antibiotic prescription within 2 days of admission. Sensitivity analyses using inverse probability weighting and generalized estimating equation were also performed.<h4>Results</h4>Eligible patients (n = 144,110) were divided into antibiotic prescription (n = 3,873) and control (n = 140,237) groups. One-to-one propensity score matching identified 3,861 pairs of patients who received antibiotic prescriptions within 2 days of admission. Following this, antibiotic prescription was associated with a decreased 28-day mortality rate (2.3% vs. 3.6%) and in-hospital mortality rate (4.0% vs. 5.0%) compared with the control group. Conversely, antibiotics increased Clostridioides difficile infection (CDI) compared with the control group (0.6% vs. 0.1%). No statistical differences were observed between both groups regarding acute kidney injury (0.4% vs. 0.2%). Sensitivity analysis showed similar outcomes.<h4>Conclusions</h4>This multicenter observational study in Japan showed that antibiotic prescriptions were associated with lower 28-day and in-hospital mortalities and an increased CDI risk in non-critically ill hospitalized patients with COVID-19.https://doi.org/10.1371/journal.pone.0318803 |
| spellingShingle | Haruka Imai Jun Suzuki Tomoki Mizuno Shota Takahashi Hideya Itagaki Makiko Yoshida Shiro Endo Eiichi N Kodama The effect of antibiotic prescription in non-critically ill hospitalized patients with COVID-19: A Japanese inpatient database study. PLoS ONE |
| title | The effect of antibiotic prescription in non-critically ill hospitalized patients with COVID-19: A Japanese inpatient database study. |
| title_full | The effect of antibiotic prescription in non-critically ill hospitalized patients with COVID-19: A Japanese inpatient database study. |
| title_fullStr | The effect of antibiotic prescription in non-critically ill hospitalized patients with COVID-19: A Japanese inpatient database study. |
| title_full_unstemmed | The effect of antibiotic prescription in non-critically ill hospitalized patients with COVID-19: A Japanese inpatient database study. |
| title_short | The effect of antibiotic prescription in non-critically ill hospitalized patients with COVID-19: A Japanese inpatient database study. |
| title_sort | effect of antibiotic prescription in non critically ill hospitalized patients with covid 19 a japanese inpatient database study |
| url | https://doi.org/10.1371/journal.pone.0318803 |
| work_keys_str_mv | AT harukaimai theeffectofantibioticprescriptioninnoncriticallyillhospitalizedpatientswithcovid19ajapaneseinpatientdatabasestudy AT junsuzuki theeffectofantibioticprescriptioninnoncriticallyillhospitalizedpatientswithcovid19ajapaneseinpatientdatabasestudy AT tomokimizuno theeffectofantibioticprescriptioninnoncriticallyillhospitalizedpatientswithcovid19ajapaneseinpatientdatabasestudy AT shotatakahashi theeffectofantibioticprescriptioninnoncriticallyillhospitalizedpatientswithcovid19ajapaneseinpatientdatabasestudy AT hideyaitagaki theeffectofantibioticprescriptioninnoncriticallyillhospitalizedpatientswithcovid19ajapaneseinpatientdatabasestudy AT makikoyoshida theeffectofantibioticprescriptioninnoncriticallyillhospitalizedpatientswithcovid19ajapaneseinpatientdatabasestudy AT shiroendo theeffectofantibioticprescriptioninnoncriticallyillhospitalizedpatientswithcovid19ajapaneseinpatientdatabasestudy AT eiichinkodama theeffectofantibioticprescriptioninnoncriticallyillhospitalizedpatientswithcovid19ajapaneseinpatientdatabasestudy AT harukaimai effectofantibioticprescriptioninnoncriticallyillhospitalizedpatientswithcovid19ajapaneseinpatientdatabasestudy AT junsuzuki effectofantibioticprescriptioninnoncriticallyillhospitalizedpatientswithcovid19ajapaneseinpatientdatabasestudy AT tomokimizuno effectofantibioticprescriptioninnoncriticallyillhospitalizedpatientswithcovid19ajapaneseinpatientdatabasestudy AT shotatakahashi effectofantibioticprescriptioninnoncriticallyillhospitalizedpatientswithcovid19ajapaneseinpatientdatabasestudy AT hideyaitagaki effectofantibioticprescriptioninnoncriticallyillhospitalizedpatientswithcovid19ajapaneseinpatientdatabasestudy AT makikoyoshida effectofantibioticprescriptioninnoncriticallyillhospitalizedpatientswithcovid19ajapaneseinpatientdatabasestudy AT shiroendo effectofantibioticprescriptioninnoncriticallyillhospitalizedpatientswithcovid19ajapaneseinpatientdatabasestudy AT eiichinkodama effectofantibioticprescriptioninnoncriticallyillhospitalizedpatientswithcovid19ajapaneseinpatientdatabasestudy |