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Int J Antimicrobial Agents: 无菌感染的非重症COVID-19患者早期使用抗生素并不能获得有效的治疗效果

2021-10-28 MedSci原创 MedSci原创

自2019年12月以来,由新冠病毒 (SARS-CoV-2) 引起的2019年冠状病毒病 (COVID-19) 在全球范围内迅速传播。

     这次新冠大流行给当前的全球卫生系统带来了重大挑战,但是到目前为止仍然没有针对新冠病毒(COVID-19)的特定药物。尽管不建议对病毒感染患者进行抗生素治疗,但在某些国家/地区使用抗生素很常见,尤其是在COVID-19患者患病的早期阶段。最近的一项荟萃分析显示,在全球大流行的前6个月,为COVID-19患者开具抗生素处方的概率为 74.6%。由于COVID-19的临床症状与细菌性肺炎相似,如咳嗽、发热、乏力等,当这些疾病诊断无法有效识别时,临床医生通常会对患者进行经验性或预防性抗生素治疗。本研究旨在评估早期抗生素使用对无细菌感染的非重症 COVID-19 患者的影响。

 

       这项研究为多中心回顾性队列研究,总共纳入1,373 名因无细菌感染入院的非重症 COVID-19 住院患者。根据患者入院后 48 小时内接触抗生素的情况,将患者分为两组,接受抗生素治疗组和未接受抗生素治疗组。主要观察结果是从非严重型 COVID-19 发展为严重型、住院时间超过 15 天和死亡率的情况。使用混合效应 Cox 模型和随机效应逻辑回归来探索早期抗生素使用与主要结果之间的关联。

 

      在30天的随访中,早期抗生素使用组进展为重症COVID-19的患者比例几乎是对照组的1.4倍。在混合效应模型中,早期使用抗生素与发展为重症和住院超过 15 天的可能性更高有关。然而,早期使用抗生素与死亡率之间没有显着关联。在亚组分析中,研究人员发现接受任何类别抗生素的患者出现不良健康结果的风险明显增加。阿奇霉素并没有改善 COVID-19 患者的疾病进展和住院时间。

 

       本研究发现,在非重症 COVID-19 患者中早期使用抗生素与从非重症进展为重症的风险以及住院时间延长显着相关。研究人员还发现使用阿奇霉素与更好的临床结果无关。因此,研究人员建议在没有细菌感染证据的情况下,应避免在非重症 COVID-19 患者中使用抗生素。

 

 

 

原始出处:

XiaoxvYin. Et al. Evaluation of early antibiotic use in non-severe COVID-19 patients without bacterial infection: Early antibiotic use in non-severe COVID-19. International Journal of Antimicrobial Agents.2021.

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    2021-11-13 grace5700
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    2022-01-19 wjywjy
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    2022-06-23 xjy02
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