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To characterise the factors, outcomes and infections associated with antibiotic use in COVID-19 patients. Records of patients with RT-PCR-confirmed COVID-19, hospitalized at the CHU Charleroi (Belgium) between 11 March and 3 May 3 2020, were retrospectively reviewed. Factors associated with antibiotic treatment, outcomes and bacterial infections were analysed. Among the 164 hospitalized COVID-19 patients (median age 60.5 years [IQR] 46–79), twenty-five (15.2%) were admitted to the ICU. Twenty-six (15.9%) died in the hospital. One hundred (61%) received antibiotic treatment. Combination therapies with macrolides were more common in the early part of the study period (26/67, 38.8%). Twenty-eight patients (17.1%) had a confirmed infection, mostly of the urinary tract (18/28, 64.3%). Only 2 (1.2%) had a documented respiratory coinfection. Six of the 7 ICU infections (85.7%) were superinfections. Gram-negative bacteria were most frequently isolated. In multivariate analysis, six factors were associated with antibiotic use: being hospitalized in the ICU (OR: 4.59; 95% CI 1.07–19.71), age &gt; 65 years (OR: 4.16; 95% CI 1.72–10.05), arrival from a nursing home (OR: 4.59; 95% CI 1.11–19.71), diabetes (OR: 4.35; 95% CI 1.26–14.93), bilateral consolidation on chest CT (OR: 9.92; 95% CI 2.40–41.06) and a C-reactive protein level &gt; 60 mg/L (OR:2.46; 95% CI 1.13–5.37). Antibiotic treatment did not reduce the length of stay or the mortality rate. Antibiotics have been overused during the COVID-19 pandemic, despite a low rate of coinfections . Integrating the antimicrobial stewardship (AMS) programme into the COVID-19 response is essential.

Antibiotic use in patients with Coronavirus disease 2019 (COVID-19): outcomes and associated factors