In a recent study, researchers examined the use of empiric antibiotics to ascertain the prevalence rates of community-acquired bacterial co-infections among hospitalized pediatric severe COVID-19 patients in a study just published in Open Forum Infectious Diseases.

They examined patients under 19 years from March 2020 to December 2020 who had been hospitalized in pediatric high-acuity units (HAU) or intensive care units (ICU) because of SARS-CoV-2 infections. Based on microbiology findings from the first 72 hours of hospitalization, the team determined if patients had co-infections with community-acquired germs.

Patients diagnosed with multisystem inflammatory syndrome in children (MIS-C) were not included in the study according to the Centers for Disease Control and Prevention (CDC) criteria. 

Results showed that 63.0% of 532 people received empiric antibiotics, yet only 7% experienced bacterial co-infections. Immunosuppressed patients, those needing breathing aids other than mechanical ventilators, or those needing invasive mechanical ventilators had a higher risk of receiving empirical antibiotic prescriptions.

Ceftriaxone (41%) and vancomycin (28%), followed by cefepime (20%), were the most commonly prescribed antibiotics. In the first two days after being admitted to the hospital, 21%, 10%, and 18% of the patients received 2.0, 3.0, and 4.0 antibiotics, respectively. Without bacterial co-infections, more than 33% of patients took antibiotics for 5.0 days. Compared to individuals who did not take antibiotics, the median social vulnerability index (SVI) scores were considerably higher in the antibiotic group.

Antibiotic use was related to COVID-19 severity. Most lung co-infections were caused by Staphylococcus aureus and / or Pseudomonas aeruginosa, which were linked to higher PEdiatric Logistic Organ Dysfunction-2 (PELOD-2) scores at admission.

Overall, the studys findings demonstrated that although empiric antibiotics are typically recommended, community-onset bacterial co-infections among kids with critical COVID-19 are uncommon. The studys conclusions support immediate de-escalation when case assessments show that co-infections are unlikely and guide the use of antibiotics.

(Source:  https://www.news-medical.net/news/20230308/Study-finds-community-onset-bacterial-coinfection-in-children-with-critical-COVID-19-is-infrequent-but-empiric-antibiotics-are-commonly-prescribed.aspx)