No routine use of antibiotics in the management of confirmed COVID-19 infection

Objectives:
What is the burden of co-infections in patients with COVID-19?

Study design:
This review article included 30 studies (29 observational studies and one RCT) with a total of 3,834 COVID-19 patients.

Three studies reported fungal co-infections.

Results and conclusions:   
The investigators found, overall, 7% of hospitalised COVID-19 patients had a bacterial co-infection [95% CI = 3% to 12%, n = 2,183, I2 = 92.2%].

The investigators found a higher proportion of ICU patients had bacterial co-infections than patients in mixed ward/ICU settings [14%, 95% CI = 5% to 26%, I2 = 74.7% versus 4%, 95% CI = 1% to 9%, I2 = 91.7%].

The investigators found the commonest bacteria were Mycoplasma pneumonia, Pseudomonas aeruginosa and Haemophilus influenzae.

The investigators found the pooled proportion with a viral co-infection was 3% [95% CI = 1% to 6%, n = 1,014, I2 = 62.3%], with Respiratory Syncytial Virus and influenza A the commonest.

The investigators concluded that the overall proportion of COVID-19 patients who have a bacterial coinfection is lower than in previous influenza pandemics, with little evidence of S.aureus, S.pneumoniae or S.pyogenes having a major role. Therefore, these findings do not support the routine use of antibiotics in the management of confirmed COVID-19 infection.

Original title:
Co-infections in People With COVID-19: A Systematic Review and Meta-Analysis by Lansbury L, Lim B, […], Lim WS.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7255350/

Additional information of El Mondo:
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