Implications of Antibiotics Use during the COVID-19 Pandemic: Present and Future

A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Antibiotics Use and Antimicrobial Stewardship".

Deadline for manuscript submissions: closed (31 May 2022) | Viewed by 21249

Special Issue Editor


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Guest Editor
Grupo de Investigación Biomedicina, Faculty of Medicine, Fundacion Universitaria Autonoma de las Américas, Sede Pereira, Pereira, Risaralda, Colombia
Interests: virology; clinical microbiology; tropical and emergent pathogens; molecular epidemiology; COVID-19; antimicrobial stedwarship in COVID-19
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Special Issue Information

Dear Colleagues,

The coronavirus disease 2019 (COVID-19) pandemic, caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), has had a global impact, leading to more than 120 million cases confirmed and more than 2.6 million deaths reported as of March 16, 2021. The implications on the management of patients including multiple aspects, such as the repurposing of antimicrobials, as in the case of antibiotics, but also the therapy of bacterial secondary infections and coinfections, have been matters of concern since the beginning of the pandemic. This Special Issue will present emerging concepts regarding the implications of antibiotics use during the COVID-19 pandemic, searching for further understanding of the current evidence and future scenarios.

Prof. Dr. Alfonso J. Rodriguez-Morales
Guest Editor

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Keywords

  • antibiotic
  • antimicrobial
  • repurposing
  • COVID-19
  • SARS-CoV-2
  • pandemic
  • coinfections
  • secondary infection
  • bacteria
  • virus

Published Papers (5 papers)

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Editorial

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3 pages, 201 KiB  
Editorial
Implications of Antibiotic Use during the COVID-19 Pandemic: The Example of Associated Antimicrobial Resistance in Latin America
by Carlos Álvarez-Moreno, Sandra Valderrama-Beltrán and Alfonso J. Rodriguez-Morales
Antibiotics 2021, 10(3), 328; https://doi.org/10.3390/antibiotics10030328 - 20 Mar 2021
Cited by 11 | Viewed by 5167
Abstract
Antimicrobials are essential for infection management [...] Full article

Research

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16 pages, 1832 KiB  
Article
The Impact of Multiplex PCR in Diagnosing and Managing Bacterial Infections in COVID-19 Patients Self-Medicated with Antibiotics
by Iulia Bogdan, Cosmin Citu, Felix Bratosin, Daniel Malita, Ioan Romosan, Camelia Vidita Gurban, Adrian Vasile Bota, Mirela Turaiche, Melania Lavinia Bratu, Ciprian Nicolae Pilut and Iosif Marincu
Antibiotics 2022, 11(4), 437; https://doi.org/10.3390/antibiotics11040437 - 24 Mar 2022
Cited by 17 | Viewed by 2918
Abstract
The multiplex PCR is a powerful and efficient tool that was widely used during the COVID-19 pandemic to diagnose SARS-CoV-2 infections and that has applications for bacterial identification, as well as determining bacterial resistance to antibiotics. Therefore, this study aimed to determine the [...] Read more.
The multiplex PCR is a powerful and efficient tool that was widely used during the COVID-19 pandemic to diagnose SARS-CoV-2 infections and that has applications for bacterial identification, as well as determining bacterial resistance to antibiotics. Therefore, this study aimed to determine the usability of multiplex PCR, especially in patients self-medicated with antibiotics, where bacterial cultures often give false-negative results. A cross-sectional study was developed in two COVID-19 units, where 489 eligible patients were included as antibiotic takers and non-antibiotic takers. Antibiotic takers used mostly over-the-counter medication; they suffered significantly more chronic respiratory conditions and were self-medicated most often with cephalosporins (41.4%), macrolide (23.2%), and penicillin (19.7%). The disease severity in these patients was significantly higher than in non-antibiotic takers, and bacterial superinfections were the most common finding in the same group (63.6%). Antibiotic takers had longer hospital and ICU admissions, although the mortality rate was not significantly higher than in non-antibiotic takers. The most common bacteria involved in secondary infections were Staphylococcus aureus (22.2%), Pseudomonas aeruginosa (27.8%), and Klebsiellaspp (25.0%). Patients self-medicating with antibiotics had significantly higher rates of multidrug resistance. The multiplex PCR test was more accurate in identifying multidrug resistance and resulted in a quicker initiation of therapeutic antibiotics compared with instances where a bacterial culture was initially performed, with an average of 26.8 h vs. 40.4 h, respectively. The hospital stay was also significantly shorter by an average of 2.5 days when PCR was used as an initial assessment tool for secondary bacterial infections. When adjusted for age, COVID-19 severity, and pulmonary disease, over-the-counter use of antibiotics represented a significant independent risk factor for a prolonged hospitalization (AOR = 1.21). Similar findings were observed for smoking status (AOR = 1.44), bacterial superinfection (AOR = 1.52), performing only a conventional bacterial culture (AOR = 1.17), and a duration of more than 48 h for bacterial sampling from the time of hospital admission (AOR = 1.36). Multiplex PCR may be a very effective method for diagnosing secondary bacterial infections in COVID-19 individuals self-medicating with antibiotics. Utilizing this strategy as an initial screen in COVID-19 patients who exhibit signs of sepsis and clinical deterioration will result in a faster recovery time and a shorter period of hospitalization. Full article
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13 pages, 744 KiB  
Article
Identification of Coinfections by Viral and Bacterial Pathogens in COVID-19 Hospitalized Patients in Peru: Molecular Diagnosis and Clinical Characteristics
by Giancarlo Pérez-Lazo, Wilmer Silva-Caso, Juana del Valle-Mendoza, Adriana Morales-Moreno, José Ballena-López, Fernando Soto-Febres, Johanna Martins-Luna, Hugo Carrillo-Ng, Luís J. del Valle, Sungmin Kym, Miguel Angel Aguilar-Luis, Issac Peña-Tuesta, Carmen Tinco-Valdez and Luis Ricardo Illescas
Antibiotics 2021, 10(11), 1358; https://doi.org/10.3390/antibiotics10111358 - 07 Nov 2021
Cited by 8 | Viewed by 3112
Abstract
The impact of respiratory coinfections in COVID-19 is still not well understood despite the growing evidence that consider coinfections greater than expected. A total of 295 patients older than 18 years of age, hospitalized with a confirmed diagnosis of moderate/severe pneumonia due to [...] Read more.
The impact of respiratory coinfections in COVID-19 is still not well understood despite the growing evidence that consider coinfections greater than expected. A total of 295 patients older than 18 years of age, hospitalized with a confirmed diagnosis of moderate/severe pneumonia due to SARS-CoV-2 infection (according to definitions established by the Ministry of Health of Peru) were enrolled during the study period. A coinfection with one or more respiratory pathogens was detected in 154 (52.2%) patients at hospital admission. The most common coinfections were Mycoplasma pneumoniae (28.1%), Chlamydia pneumoniae (8.8%) and with both bacteria (11.5%); followed by Adenovirus (1.7%), Mycoplasma pneumoniae/Adenovirus (0.7%), Chlamydia pneumoniae/Adenovirus (0.7%), RSV-B/Chlamydia pneumoniae (0.3%) and Mycoplasma pneumoniae/Chlamydia pneumoniae/Adenovirus (0.3%). Expectoration was less frequent in coinfected individuals compared to non-coinfected (5.8% vs. 12.8%). Sepsis was more frequent among coinfected patients than non-coinfected individuals (33.1% vs. 20.6%) and 41% of the patients who received macrolides empirically were PCR-positive for Mycoplasma pneumoniae and Chlamydia pneumoniae. Full article
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17 pages, 627 KiB  
Article
Antibiotic Use and Fatal Outcomes among Critically Ill Patients with COVID-19 in Tacna, Peru
by Cesar Copaja-Corzo, Miguel Hueda-Zavaleta, Vicente A. Benites-Zapata and Alfonso J. Rodriguez-Morales
Antibiotics 2021, 10(8), 959; https://doi.org/10.3390/antibiotics10080959 - 09 Aug 2021
Cited by 10 | Viewed by 4498
Abstract
Overuse of antibiotics during the Coronavirus Disease 2019 (COVID-19) pandemic could increase the selection of extensively resistant bacteria (XDR). However, it is unknown what impact they could have on the evolution of patients, particularly critically ill patients. This study aimed to evaluate the [...] Read more.
Overuse of antibiotics during the Coronavirus Disease 2019 (COVID-19) pandemic could increase the selection of extensively resistant bacteria (XDR). However, it is unknown what impact they could have on the evolution of patients, particularly critically ill patients. This study aimed to evaluate the characteristics and impact of ICU-acquired infections in patients with COVID-19. A retrospective cohort study was conducted, evaluating all patients with critical COVID-19 admitted to the intensive care unit (ICU) of a hospital in Southern Peru from 28 March 2020 to 1 March 2021. Of the 124 patients evaluated, 50 (40.32%) developed a healthcare-associated infection (HAI), which occurred at a median of 8 days (IQR 6–17) after ICU admission. The proportion of patients with HAI that required ceftriaxone was significantly higher; the same was true for the use of dexamethasone. Forty bacteria isolations (80%) were classified as XDR to antibiotics, with the most common organisms being Acinetobacter baumannii (54%) and Pseudomonas aeruginosa (22%); 33% (41/124) died at the ICU during the follow-up. In the adjusted analysis, healthcare-associated infection was associated with an increased risk of mortality (aHR= 2.7; 95% CI: 1.33–5.60) and of developing acute renal failure (aRR = 3.1; 95% CI: 1.42–6.72). The incidence of healthcare infection mainly by XDR pathogens is high in critically ill patients with COVID-19 and is associated with an increased risk of complications or death. Full article
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Review

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26 pages, 1572 KiB  
Review
Host Defence Peptides: A Potent Alternative to Combat Antimicrobial Resistance in the Era of the COVID-19 Pandemic
by Waqas Ali, Ahmad Elsahn, Darren S. J. Ting, Harminder S. Dua and Imran Mohammed
Antibiotics 2022, 11(4), 475; https://doi.org/10.3390/antibiotics11040475 - 01 Apr 2022
Cited by 9 | Viewed by 3426
Abstract
One of the greatest challenges facing the medical community today is the ever-increasing trajectory of antimicrobial resistance (AMR), which is being compounded by the decrease in our antimicrobial armamentarium. From their initial discovery to the current day, antibiotics have seen an exponential increase [...] Read more.
One of the greatest challenges facing the medical community today is the ever-increasing trajectory of antimicrobial resistance (AMR), which is being compounded by the decrease in our antimicrobial armamentarium. From their initial discovery to the current day, antibiotics have seen an exponential increase in their usage, from medical to agricultural use. Benefits aside, this has led to an exponential increase in AMR, with the fear that over 10 million lives are predicted to be lost by 2050, according to the World Health Organisation (WHO). As such, medical researchers are turning their focus to discovering novel alternatives to antimicrobials, one being Host Defence Peptides (HDPs). These small cationic peptides have shown great efficacy in being used as an antimicrobial therapy for currently resistant microbial variants. With the sudden emergence of the SARS-CoV-2 variant and the subsequent global pandemic, the great versatility and potential use of HDPs as an alternative to conventional antibiotics in treating as well as preventing the spread of COVID-19 has been reviewed. Thus, to allow the reader to have a full understanding of the multifaceted therapeutic use of HDPs, this literature review shall cover the association between COVID-19 and AMR whilst discussing and evaluating the use of HDPs as an answer to antimicrobial resistance (AMR). Full article
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