PD090 - ANTIMICROBIAL PRESCRIBING IN HOSPITALIZED CHILDREN WITH COVID-19 (ID 816)
Abstract
Backgrounds:
Antimicrobial consumption has increased during the COVID-19 pandemic especially in hospitalized adults with COVID-19. This study aims to analyze the co-infections, prevalence and characteristics of antimicrobial use in hospitalized children with COVID-19.
Methods
A single-center retrospective study was performed between March 2020 and December 2021 in children admitted to a COVID-19 referral pediatric hospital, following a positive RT-PCR for SARS-CoV-2. Medical records of children with COVID-19 were reviewed for demographics, clinical characteristics and data on antimicrobial administration.
Results:
A total of 299 children with confirmed COVID-19 were enrolled. Antimicrobial use was documented in 75 (25%) patients (male:53,3%; median age:4 years, IQR:12). The median duration of hospitalization was 5 days and the mean duration of antimicrobial use was 5 days. The most frequently prescribed antimicrobials were penicillins (36%), cefotaxime (24%), ampicillin plus gentamicin (16%) and macrolides (13,3%). Secondary bacterial infection or co-infection was reported in 26,6% of children who received antimicrobials. Antimicrobials were administered in 41,3% of children with severe disease (mean antimicrobial duration: 5 days), in 58,3% with abnormal chest imaging and in 32% with increased C-reactive protein (>60mg/L). A mean of 1.2 antimicrobials was prescribed per patient and they were stopped or de-escalated within 72 h in 48%, without supporting clinical, radiological or laboratory evidence of bacterial infection, while in 29,3% of these were neonates.
Conclusions/Learning Points:
25% of hospitalized children with COVID-19 received antimicrobials for suspected bacterial. Most patients received narrow spectrum antibiotics. Diagnostic criteria should be applied to avoid unnecessary prescribing in the context of COVID-19 infection.
