Antimicrobial Use during the SARS-CoV-2 Pandemic in a Greek Tertiary University Hospital

• Published in: Microorganisms (Basel) Vol. 12; no. 3; p. 623
• Main Authors: Biros, Dimitrios, Filippas-Ntekouan, Sempastian, Limperatou, Diamantina, Liontos, Angelos, Matzaras, Rafail, Tsarapatsani, Konstantina-Helen, Kolios, Nikolaos-Gavriel, Pappa, Christiana, Nasiou, Maria, Pargana, Eleni, Tsiakas, Ilias, Samanidou, Valentini, Athanasiou, Lazaros, Konstantopoulou, Revekka, Milionis, Haralampos, Christaki, Eirini
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01.03.2024; MDPI
• Subjects: Anti-infective agents; antibiotic use; Antibiotics; Antimicrobial agents; antimicrobial stewardship; bacterial co-infection; Bacterial infections; C-reactive protein; Cardiovascular disease; Comorbidity; COVID-19; COVID-19 vaccines; Drug resistance; Epidemics; Greece; Hospitalization; Hospitals; Infections; Medical research; Medicine, Experimental; Mortality; Pandemics; Pneumonia; Population; Primary care; Procalcitonin; Proteins; Regression analysis; Risk factors; Severe acute respiratory syndrome coronavirus 2; Steroids; Vaccination; Viral diseases; Greece; COVID-19; bacterial co-infection; antibiotic use; antimicrobial stewardship
• ISSN: 2076-2607; 2076-2607
• DOI: 10.3390/microorganisms12030623

In cases of SARS-CoV-2 hospitalization, despite low bacterial co-infection rates, antimicrobial use may be disproportionately high. Our aim was to quantify such usage in COVID-19 patients and identify factors linked to increased antibiotic use. We retrospectively studied patients with SARS-CoV-2 infection who were hospitalized at our institution during the pandemic. In the initial two waves of the pandemic, antimicrobial use was notably high (89% in the first wave and 92% in the second), but it decreased in subsequent waves. Elevated procalcitonin (>0.5 μg/mL) and C-reactive protein (>100 mg/L) levels were linked to antibiotic usage, while prior vaccination reduced antibiotic incidence. Antimicrobial use decreased in the pandemic, suggesting enhanced comprehension of SARS-CoV-2's natural course. Additionally, it was correlated with heightened SARS-CoV-2 severity, elevated procalcitonin, and C-reactive protein levels.