Observational Study on Secondary Bacterial Infection and the Use of Antibiotics in COVID-19 Patients Treated in a Tertiary Referral Hospital

Authors

  • Khie Chen Lie 1. Division of Tropical and Infectious Disease, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia – Cipto Mangunkusumo Hospital, Jakarta, Indonesia. 2. Member of Antimicrobial Stewardship Committee, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
  • Sharifah Shakinah Division of Tropical and Infectious Disease, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia – Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Adeline Pasaribu Division of Tropical and Infectious Disease, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia – Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Robert Sinto 1. Division of Tropical and Infectious Disease, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia – Cipto Mangunkusumo Hospital, Jakarta, Indonesia. 2. Member of Antimicrobial Stewardship Committee, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
  • Leonard Nainggolan 1. Division of Tropical and Infectious Disease, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia – Cipto Mangunkusumo Hospital, Jakarta, Indonesia. 2. Member of Antimicrobial Stewardship Committee, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.

Keywords:

COVID-19, secondary bacterial infection, antibiotics, antibiotic stewardship

Abstract

Background: Data on secondary bacterial infection in patients with COVID-19 in Indonesia are still limited, while the use of empirical antibiotics continues to increase. This study aims to determine the secondary bacterial infection rate in hospitalized COVID-19 patients and factors related to secondary bacterial infection. Methods: This is a retrospective cohort study on hospitalized COVID-19 patients undergoing treatment at Cipto Mangunkusumo Hospital from March 2020 to September 2020. Secondary bacterial infection is defined as the identification of a bacterial pathogen from a microbiological examination. Results: From a total of 255 subjects, secondary infection was identified in 14.5%. Predictors of secondary infection were early symptoms of shortness of breath (OR 5.31, 95% CI 1.3 – 21.5), decreased consciousness (OR 4.81, 95% CI 1.77 – 13.0), length of stay > 12 days (OR 8.2, 95% CI 2.9 – 23.3), and central venous catheter placement (OR 3.0, 95% CI 1.1 – 8.0) The most common pathogen of secondary bacterial infection is Acinetobacter sp. (n=9; 28%). Empirical antibiotics were administered to 82.4% of subjects with predominant use of macrolides (n=141; 32.4%). Conclusion: The secondary bacterial infection rate in COVID-19 was 14.5% and is associated with dyspnea, decreased consciousness, length of stay >12 days, and central venous catheter placement. The use of antibiotics in COVID-19 reaches 82.4% and requires special attention to prevent the occurrence of antibiotic resistance.

Author Biography

Khie Chen Lie, 1. Division of Tropical and Infectious Disease, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia – Cipto Mangunkusumo Hospital, Jakarta, Indonesia. 2. Member of Antimicrobial Stewardship Committee, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.

Internal Medicine Department, FKUI

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Published

2022-07-07

How to Cite

Lie, K. C., Shakinah, S., Pasaribu, A., Sinto, R., & Nainggolan, L. (2022). Observational Study on Secondary Bacterial Infection and the Use of Antibiotics in COVID-19 Patients Treated in a Tertiary Referral Hospital. Acta Medica Indonesiana, 54(2), 161. Retrieved from https://actamedindones.org/index.php/ijim/article/view/2075