Continuation Versus De-escalation of Broad-Spectrum Antibiotic Therapy in Critically Ill COVID-19 Patients
Background Antibiotic de-escalation (ADE) is a stewardship initiative that aims to reduce exposure to antimicrobials, thus limiting their unwanted effect, including antimicrobial resistance. Our study aims to describe the impact of ADE compared with the continuation of therapy on the outcome of crit...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2023-04-01
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| Series: | Dr. Sulaiman Al Habib Medical Journal |
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| Online Access: | https://journals.lww.com/10.1007/s44229-023-00027-0 |
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| author | Namareq F. Aldardeer Abeer Nizar A. L. Shukairi Mohannad E. Nasser Mohammad Al Musawa Bayader S. Kalkatawi Reem M. Alsahli Aiman M. Elsaed Ramdan Ismael Qushmaq Mohammed Aldhaeefi |
| author_facet | Namareq F. Aldardeer Abeer Nizar A. L. Shukairi Mohannad E. Nasser Mohammad Al Musawa Bayader S. Kalkatawi Reem M. Alsahli Aiman M. Elsaed Ramdan Ismael Qushmaq Mohammed Aldhaeefi |
| author_sort | Namareq F. Aldardeer |
| collection | DOAJ |
| description | Background
Antibiotic de-escalation (ADE) is a stewardship initiative that aims to reduce exposure to antimicrobials, thus limiting their unwanted effect, including antimicrobial resistance. Our study aims to describe the impact of ADE compared with the continuation of therapy on the outcome of critically ill coronavirus disease 2019 (COVID-19) patients.
Material and Methods
A single-center retrospective study included critically ill COVID-19 adult patients admitted between January 1, 2019 and August 31, 2021, and started on broad-spectrum antibiotics. The primary outcome was intensive care unit (ICU) mortality. In addition, other clinical outcomes were evaluated, including ICU readmissions, length of stay, and superinfection.
Results
The study included 73 patients with a mean age of 61.0 ± 19.4, and ADE was performed in 10 (13.6%) of these. In the ADE group, 8/10 (80%) cultures were positive. ICU mortality was not statistically different between ADE and continuation of therapy groups (60 vs. 41.3%, respectively, P ≤ 0.317). Superinfection occurred in 4 (5.4%) patients. Hospital mortality, length of stay, and ICU readmission rates did not differ significantly between groups.
Conclusion
De-escalation of broad-spectrum antibiotics in critically ill covid-19 patients was not associated with higher mortality. A larger cohort is needed to confirm these findings. |
| format | Article |
| id | doaj-art-5b47a4b85d2c4b64860e8bd496a34b5f |
| institution | DOAJ |
| issn | 2666-819X 2590-3349 |
| language | English |
| publishDate | 2023-04-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Dr. Sulaiman Al Habib Medical Journal |
| spelling | doaj-art-5b47a4b85d2c4b64860e8bd496a34b5f2025-08-20T03:03:20ZengWolters Kluwer Medknow PublicationsDr. Sulaiman Al Habib Medical Journal2666-819X2590-33492023-04-0152334110.1007/s44229-023-00027-0Continuation Versus De-escalation of Broad-Spectrum Antibiotic Therapy in Critically Ill COVID-19 PatientsNamareq F. AldardeerAbeer Nizar A. L. ShukairiMohannad E. NasserMohammad Al MusawaBayader S. KalkatawiReem M. AlsahliAiman M. Elsaed RamdanIsmael QushmaqMohammed AldhaeefiBackground Antibiotic de-escalation (ADE) is a stewardship initiative that aims to reduce exposure to antimicrobials, thus limiting their unwanted effect, including antimicrobial resistance. Our study aims to describe the impact of ADE compared with the continuation of therapy on the outcome of critically ill coronavirus disease 2019 (COVID-19) patients. Material and Methods A single-center retrospective study included critically ill COVID-19 adult patients admitted between January 1, 2019 and August 31, 2021, and started on broad-spectrum antibiotics. The primary outcome was intensive care unit (ICU) mortality. In addition, other clinical outcomes were evaluated, including ICU readmissions, length of stay, and superinfection. Results The study included 73 patients with a mean age of 61.0 ± 19.4, and ADE was performed in 10 (13.6%) of these. In the ADE group, 8/10 (80%) cultures were positive. ICU mortality was not statistically different between ADE and continuation of therapy groups (60 vs. 41.3%, respectively, P ≤ 0.317). Superinfection occurred in 4 (5.4%) patients. Hospital mortality, length of stay, and ICU readmission rates did not differ significantly between groups. Conclusion De-escalation of broad-spectrum antibiotics in critically ill covid-19 patients was not associated with higher mortality. A larger cohort is needed to confirm these findings.https://journals.lww.com/10.1007/s44229-023-00027-0covid-19intensive care unitde-escalationbroad-spectrumantibiotic |
| spellingShingle | Namareq F. Aldardeer Abeer Nizar A. L. Shukairi Mohannad E. Nasser Mohammad Al Musawa Bayader S. Kalkatawi Reem M. Alsahli Aiman M. Elsaed Ramdan Ismael Qushmaq Mohammed Aldhaeefi Continuation Versus De-escalation of Broad-Spectrum Antibiotic Therapy in Critically Ill COVID-19 Patients Dr. Sulaiman Al Habib Medical Journal covid-19 intensive care unit de-escalation broad-spectrum antibiotic |
| title | Continuation Versus De-escalation of Broad-Spectrum Antibiotic Therapy in Critically Ill COVID-19 Patients |
| title_full | Continuation Versus De-escalation of Broad-Spectrum Antibiotic Therapy in Critically Ill COVID-19 Patients |
| title_fullStr | Continuation Versus De-escalation of Broad-Spectrum Antibiotic Therapy in Critically Ill COVID-19 Patients |
| title_full_unstemmed | Continuation Versus De-escalation of Broad-Spectrum Antibiotic Therapy in Critically Ill COVID-19 Patients |
| title_short | Continuation Versus De-escalation of Broad-Spectrum Antibiotic Therapy in Critically Ill COVID-19 Patients |
| title_sort | continuation versus de escalation of broad spectrum antibiotic therapy in critically ill covid 19 patients |
| topic | covid-19 intensive care unit de-escalation broad-spectrum antibiotic |
| url | https://journals.lww.com/10.1007/s44229-023-00027-0 |
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