Role of antibiotics in coronavirus 2019

Elassal, G.; Othman, N.

During the current COVID-19 pandemic, there are potential threats that could affect antimicrobial stewardship activities and drive antimicrobial resistance. For instance, many individuals presenting with mild disease without pneumonia or moderate disease with pneumonia receive antibiotics. Zhou et al. [5] showed that in the current coronavirus disease 2019 (COVID-19) pandemic, 50% of patients with COVID-19 who have died had secondary bacterial infections. Rapid characterization of coinfection is essential. It will save lives. Notably, among COVID-19 ICU cases in Zhongnan Hospital, there was a high reported frequency of secondary infections with carbapenem-resistant Acinetobacter baumannii, particularly among ICU deaths. The standard empiric antibacterial treatment should be initially prescribed for adults with clinical and radiographic evidence of CAP who test positive in the inpatient and outpatient settings. If hydroxychloroquine is being used for COVID-19 treatment, avoid antibiotics that also prolong QTc interval (e.g. levofloxacin, azithromycin).