ArticlePloS one2025
The effect of antibiotic prescription in non-critically ill hospitalized patients with COVID-19: A Japanese inpatient database study.
Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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8 authors.
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Abstract
backgroundCoronavirus disease 2019 (COVID-19) is an ongoing global pandemic. Bacterial coinfections with COVID-19 occur in 3.5% of COVID-19 cases, with a higher incidence in severe cases. Although antibiotics have been prescribed to treat non-critically ill patients with COVID-19, their effect on non-critically ill hospitalized patients with COVID-19 remains uncertain.
methodsWe analyzed data from non-critically ill hospitalized patients with COVID-19 who were older than 18 years between January 1, 2020, and May 31, 2023. We performed propensity score matching analysis, evaluating in-hospital mortality with or without antibiotic prescription within 2 days of admission. Sensitivity analyses using inverse probability weighting and generalized estimating equation were also performed.
resultsEligible patients (n = 144,110) were divided into antibiotic prescription (n = 3,873) and control (n = 140,237) groups. One-to-one propensity score matching identified 3,861 pairs of patients who received antibiotic prescriptions within 2 days of admission. Following this, antibiotic prescription was associated with a decreased 28-day mortality rate (2.3% vs. 3.6%) and in-hospital mortality rate (4.0% vs. 5.0%) compared with the control group. Conversely, antibiotics increased Clostridioides difficile infection (CDI) compared with the control group (0.6% vs. 0.1%). No statistical differences were observed between both groups regarding acute kidney injury (0.4% vs. 0.2%). Sensitivity analysis showed similar outcomes.
conclusionsThis multicenter observational study in Japan showed that antibiotic prescriptions were associated with lower 28-day and in-hospital mortalities and an increased CDI risk in non-critically ill hospitalized patients with COVID-19.
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