The impact of early antibiotic initiation on ICU mortality in severe COVID-19 patients.

Abstract

INTRODUCTION: Antibiotics were one of the components of the drugs used to treat COVID-19. In this study we aimed to evaluate the association between early antibiotic therapy and mortality among patients with severe COVID- 19 admitted to ICU. MATERIAL AND METHODS: This single-centre retrospective cohort study included 223 ICU patients with severe COVID-19 pneumonia who were admitted to ICU between 1 May 2020 and 1 April 2021. Patients were divided into two groups according to their exposure to antibiotics before and after ICU admission. The outcomes were mortality rate and nosocomial infection rate. Also laboratory and clinical findings and length of stay in the ICU and hospital were recorded. RESULTS: The study included 223 patients (135 males; 88 females). Antibiotics were started before ICU admission in 201 patients. During the ICU stay, there was no significant association between early use of antibiotics and mortality (p=0.114) or and length of stay in ICU (p=0.296). There was a significant difference only in lymphocyte count in terms of laboratory parameters (p=0.003). 3rd generation cephalosporins were the most frequently used antibiotics before intensive care admission. CONCLUSIONS: Our study revealed early antibiotic initiation had no mortality-reducing effect in severe COVID-19 in ICU. We concluded that avoiding routine administration of antibiotics should be convenient in COVID-19.

Keywords

• covid-19
• antibiotics
• co-infection
• antibiotic resistance.