PreprintArticleVersion 2Preserved in Portico This version is not peer-reviewed
The Impact of Antibiotic Prophylaxis in a Retrospective Cohort of Hospitalized Patients with COVID-19 Treated with the Combination of Steroids and Tocilizumab
Version 1
: Received: 24 August 2023 / Approved: 28 August 2023 / Online: 29 August 2023 (08:54:07 CEST)
Version 2
: Received: 25 September 2023 / Approved: 26 September 2023 / Online: 29 September 2023 (14:00:20 CEST)
Membrillo de Novales, F.J.; Ramírez-Olivencia, G.; Mata Forte, M.T.; Zamora Cintas, M.I.; Simón Sacristán, M.M.; Sánchez de Castro, M.; Estébanez Muñoz, M. The Impact of Antibiotic Prophylaxis on a Retrospective Cohort of Hospitalized Patients with COVID-19 Treated with a Combination of Steroids and Tocilizumab. Antibiotics2023, 12, 1515.
Membrillo de Novales, F.J.; Ramírez-Olivencia, G.; Mata Forte, M.T.; Zamora Cintas, M.I.; Simón Sacristán, M.M.; Sánchez de Castro, M.; Estébanez Muñoz, M. The Impact of Antibiotic Prophylaxis on a Retrospective Cohort of Hospitalized Patients with COVID-19 Treated with a Combination of Steroids and Tocilizumab. Antibiotics 2023, 12, 1515.
Membrillo de Novales, F.J.; Ramírez-Olivencia, G.; Mata Forte, M.T.; Zamora Cintas, M.I.; Simón Sacristán, M.M.; Sánchez de Castro, M.; Estébanez Muñoz, M. The Impact of Antibiotic Prophylaxis on a Retrospective Cohort of Hospitalized Patients with COVID-19 Treated with a Combination of Steroids and Tocilizumab. Antibiotics2023, 12, 1515.
Membrillo de Novales, F.J.; Ramírez-Olivencia, G.; Mata Forte, M.T.; Zamora Cintas, M.I.; Simón Sacristán, M.M.; Sánchez de Castro, M.; Estébanez Muñoz, M. The Impact of Antibiotic Prophylaxis on a Retrospective Cohort of Hospitalized Patients with COVID-19 Treated with a Combination of Steroids and Tocilizumab. Antibiotics 2023, 12, 1515.
Abstract
Objectives: In the context of COVID-19, patients with severe or critical illness may be more susceptible to developing secondary bacterial infections. This study aims to investigate the relationship between the use of prophylactic antibiotic therapy and the occurrence of bacterial or fungal isolates following the administration of tocilizumab in hospitalized COVID-19 patients who had previously received steroids during the first and second waves of the pandemic in Spain. Methods: This retrospective observational study included 70 patients hospitalized with COVID-19 who received tocilizumab and steroids between January and December 2020. Data on demographics, comorbidities, laboratory tests, microbiologic results, treatment, and outcomes were collected from electronic health records. Patients were divided into two groups based on the use of antibiotic prophylaxis, and the incidence of bacterial and fungal colonizations/infections was analyzed. Results: Among the included patients, 45 patients received antibiotic prophylaxis. No significant clinical differences were observed between patients based on prophylaxis use regarding the number of clinically diagnosed infections, ICU admissions, or mortality rates. However, patients who received antibiotic prophylaxis showed a higher incidence of colonization by multidrug-resistant germs compared to the subgroup that did not receive prophylaxis. The most commonly isolated microorganisms were Candida albicans, Enterococcus faecalis, Staphylococcus aureus, and Staphylococcus epidermidis. Conclusions: In this cohort of hospitalized COVID-19 patients treated with tocilizumab and steroids, the use of antibiotic prophylaxis did not reduce the incidence of secondary bacterial infections. However, it was associated with an increased incidence of colonization by multidrug-resistant organisms.
Medicine and Pharmacology, Epidemiology and Infectious Diseases
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received:
29 September 2023
Commenter:
Francisco Javier Membrillo de Novales
Commenter's Conflict of Interests:
Author
Comment:
Following submission to Antibiotics, editorial committe asked for a longer count of words, and reviewers suggested changes. This version includes these changes
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Commenter: Francisco Javier Membrillo de Novales
Commenter's Conflict of Interests: Author