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Article

In-Hospital Antibiotic Use for COVID-19: Facts and Rationales Assessed through a Mixed-Methods Study

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Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
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Department of Internal Medicine, Colentina Clinical Hospital, 020125 Bucharest, Romania
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Clinical Research Unit Bucharest, Réseau d’Epidémiologie Clinique International Francophone, 020125 Bucharest, Romania
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Internal Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700111 Iasi, Romania
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Department of Internal Medicine, Clinical Emergency Hospital Sfantul Spiridon, 700115 Iasi, Romania
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Faculty of Medicine, Ovidius University, 900527 Constanta, Romania
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Clinical Hospital of Infectious Diseases, 900178 Constanta, Romania
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Faculty of Medicine, University of Medicine and Pharmacy Craiova, 200349 Craiova, Romania
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Craiova Emergency County Hospital, 200642 Craiova, Romania
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National Institute of Infectious Diseases Prof. Dr. Matei Bals, 021125 Bucharest, Romania
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Department of Internal Medicine, Sacele County Hospital, 505600 Brasov, Romania
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Academic Editors: Shitij Arora and Leonidas Palaiodimos
J. Clin. Med. 2022, 11(11), 3194; https://doi.org/10.3390/jcm11113194
Received: 15 April 2022 / Revised: 27 May 2022 / Accepted: 31 May 2022 / Published: 2 June 2022
(This article belongs to the Collection COVID-19: Clinical Advances and Challenges)
It is well known that during the coronavirus disease 2019 (COVID-19) pandemic, antibiotics were overprescribed. However, less is known regarding the arguments that have led to this overuse. Our aim was to understand the factors associated with in-hospital antibiotic prescription for COVID-19, and the rationale behind it. We chose a convergent design for this mixed-methods study. Quantitative data was prospectively obtained from 533 adult patients admitted in six hospitals (services of internal medicine, infectious diseases and pneumology). Fifty-six percent of the patients received antibiotics. The qualitative data was obtained from interviewing 14 physicians active in the same departments in which the enrolled patients were hospitalized. Thematic analysis was used for the qualitative approach. Our study revealed that doctors based their decisions to prescribe antibiotics on a complex interplay of factors regarding the simultaneous appearance of consolidation on the chest computer tomography together with a worsening of clinical conditions suggestive of bacterial infection and/or an increase in inflammatory markers. Besides these features which might suggest bacterial co-/suprainfection, doctors also prescribed antibiotics in situations of uncertainty, in patients with severe disease, or with multiple associated comorbidities. View Full-Text
Keywords: COVID-19; SARS-CoV-2; antibiotics; antibacterial agents; mixed methods; qualitative; quantitative COVID-19; SARS-CoV-2; antibiotics; antibacterial agents; mixed methods; qualitative; quantitative
MDPI and ACS Style

Stoichitoiu, L.E.; Pinte, L.; Ceasovschih, A.; Cernat, R.C.; Vlad, N.D.; Padureanu, V.; Sorodoc, L.; Hristea, A.; Purcarea, A.; Badea, C.; Baicus, C. In-Hospital Antibiotic Use for COVID-19: Facts and Rationales Assessed through a Mixed-Methods Study. J. Clin. Med. 2022, 11, 3194. https://doi.org/10.3390/jcm11113194

AMA Style

Stoichitoiu LE, Pinte L, Ceasovschih A, Cernat RC, Vlad ND, Padureanu V, Sorodoc L, Hristea A, Purcarea A, Badea C, Baicus C. In-Hospital Antibiotic Use for COVID-19: Facts and Rationales Assessed through a Mixed-Methods Study. Journal of Clinical Medicine. 2022; 11(11):3194. https://doi.org/10.3390/jcm11113194

Chicago/Turabian Style

Stoichitoiu, Laura Elena, Larisa Pinte, Alexandr Ceasovschih, Roxana Carmen Cernat, Nicoleta Dorina Vlad, Vlad Padureanu, Laurentiu Sorodoc, Adriana Hristea, Adrian Purcarea, Camelia Badea, and Cristian Baicus. 2022. "In-Hospital Antibiotic Use for COVID-19: Facts and Rationales Assessed through a Mixed-Methods Study" Journal of Clinical Medicine 11, no. 11: 3194. https://doi.org/10.3390/jcm11113194

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