Is there a need to widely prescribe antibiotics in patients hospitalized for COVID-19?

Moretto, F.; Sixt, T.; Devilliers, H.; Abdallahoui, M.; Eberl, I.; Rogier, T.; Buisson, M.; Chavanet, P.; Duong, M.; Esteve, C.; Mahy, S.; Salmon-Rousseau, A.; Catherine, F.; Blot, M.; Piroth, L.

BACKGROUND: The usefulness and benefits of wide antimicrobial therapy prescription in patients hospitalized for COVID-19 is debated. METHODS: All patients hospitalized in the infectious diseases department of Dijon (France) between the 27(th) of February and the 30(th) of April 2020 for a confirmed COVID-19 were included. Clinical, biological and radiological data were collected, as well as treatments and outcomes. An unfavorable outcome was defined as death or transfer to intensive care unit. We compared the characteristics and outcomes between patients with and without antibiotics using propensity score matching. FINDINGS: Among the 222 patients included, 174 (78%) were on antibiotics. The univariate analysis showed that patients with antibiotics were significantly older, frailer and with a more severe presentation at admission. An unfavorable outcome was more frequent in patients with antibiotic therapy (HR = 2.94, CI95%: 1.07-8.11; p = 0.04). In multivariate analysis and on propensity score, antibiotic therapy was not significantly associated with outcome (HR = 1.612, CI95%: 0.562-4.629, p = 0.37). CONCLUSION: Antibiotics were frequently prescribed in our study and associated with a more severe presentation at admission. However, receiving antibiotics was not associated with outcome, either after adjustment on a propensity score. In line with recent publication, such data argue for streamlining of antibiotic therapies in COVID-19 patients.