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Observational Study on Secondary Bacterial Infection and the Use of Antibiotics in COVID-19 Patients Treated in a Tertiary Referral Hospital

ACTA MEDICA INDONESIANA · Vol. 54 No. 2 (2022)

ISSN
2338-2732, 0125-9326
Terbit
2022-07-07
Penerbit
The Indonesian Society of Internal Medicine
Bahasa
eng

Abstrak

Background: Data on secondary bacterial infection in patients with COVID-19 in Indonesia are still limited, while the use of empirical antibiotics continues to increase. This study aims to determine the secondary bacterial infection rate in hospitalized COVID-19 patients and factors related to secondary bacterial infection. Methods: This is a retrospective cohort study on hospitalized COVID-19 patients undergoing treatment at Cipto Mangunkusumo Hospital from March 2020 to September 2020. Secondary bacterial infection is defined as the identification of a bacterial pathogen from a microbiological examination. Results: From a total of 255 subjects, secondary infection was identified in 14.5%. Predictors of secondary infection were early symptoms of shortness of breath (OR 5.31, 95% CI 1.3 – 21.5), decreased consciousness (OR 4.81, 95% CI 1.77 – 13.0), length of stay > 12 days (OR 8.2, 95% CI 2.9 – 23.3), and central venous catheter placement (OR 3.0, 95% CI 1.1 – 8.0) The most common pathogen of secondary bacterial infection is Acinetobacter sp. (n=9; 28%). Empirical antibiotics were administered to 82.4% of subjects with predominant use of macrolides (n=141; 32.4%). Conclusion: The secondary bacterial infection rate in COVID-19 was 14.5% and is associated with dyspnea, decreased consciousness, length of stay >12 days, and central venous catheter placement. The use of antibiotics in COVID-19 reaches 82.4% and requires special attention to prevent the occurrence of antibiotic resistance.

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Sumber metadata: OAI-PMH (metadata jurnal) http://www.actamedindones.org/index.php/ijim/oai, pertama di-harvest 8 Nov 2026, terakhir terlihat 8 Nov 2026.
Metadata asli (oai_dc) 
<oai_dc:dc xmlns="http://www.openarchives.org/OAI/2.0/" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/  http://www.openarchives.org/OAI/2.0/oai_dc.xsd">
	<dc:title xml:lang="en-US">Observational Study on Secondary Bacterial Infection and the Use of Antibiotics in COVID-19 Patients Treated in a Tertiary Referral Hospital</dc:title>
	<dc:creator>Lie, Khie Chen</dc:creator>
	<dc:creator>Shakinah, Sharifah</dc:creator>
	<dc:creator>Pasaribu, Adeline</dc:creator>
	<dc:creator>Sinto, Robert</dc:creator>
	<dc:creator>Nainggolan, Leonard</dc:creator>
	<dc:subject xml:lang="en-US">COVID-19</dc:subject>
	<dc:subject xml:lang="en-US">secondary bacterial infection</dc:subject>
	<dc:subject xml:lang="en-US">antibiotics</dc:subject>
	<dc:subject xml:lang="en-US">antibiotic stewardship</dc:subject>
	<dc:subject xml:lang="en-US">infectious disease</dc:subject>
	<dc:subject xml:lang="en-US">covid-19</dc:subject>
	<dc:description xml:lang="en-US">Background: Data on secondary bacterial infection in patients with COVID-19 in Indonesia are still limited, while the use of empirical antibiotics continues to increase. This study aims to determine the secondary bacterial infection rate in hospitalized COVID-19 patients and factors related to secondary bacterial infection. Methods: This is a retrospective cohort study on hospitalized COVID-19 patients undergoing treatment at Cipto Mangunkusumo Hospital from March 2020 to September 2020. Secondary bacterial infection is defined as the identification of a bacterial pathogen from a microbiological examination. Results: From a total of 255 subjects, secondary infection was identified in 14.5%. Predictors of secondary infection were early symptoms of shortness of breath (OR 5.31, 95% CI 1.3 – 21.5), decreased consciousness (OR 4.81, 95% CI 1.77 – 13.0), length of stay &amp;gt; 12 days (OR 8.2, 95% CI 2.9 – 23.3), and central venous catheter placement (OR 3.0, 95% CI 1.1 – 8.0) The most common pathogen of secondary bacterial infection is Acinetobacter sp. (n=9; 28%). Empirical antibiotics were administered to 82.4% of subjects with predominant use of macrolides (n=141; 32.4%). Conclusion: The secondary bacterial infection rate in COVID-19 was 14.5% and is associated with dyspnea, decreased consciousness, length of stay &amp;gt;12 days, and central venous catheter placement. The use of antibiotics in COVID-19 reaches 82.4% and requires special attention to prevent the occurrence of antibiotic resistance.</dc:description>
	<dc:publisher xml:lang="en-US">The Indonesian Society of Internal Medicine</dc:publisher>
	<dc:date>2022-07-07</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:identifier>http://www.actamedindones.org/index.php/ijim/article/view/2075</dc:identifier>
	<dc:source xml:lang="en-US">Acta Medica Indonesiana; Vol. 54 No. 2 (2022): Acta Medica Indonesiana; 161</dc:source>
	<dc:source>2338-2732</dc:source>
	<dc:source>0125-9326</dc:source>
	<dc:language>eng</dc:language>
	<dc:relation>http://www.actamedindones.org/index.php/ijim/article/view/2075/pdf</dc:relation>
	<dc:rights xml:lang="en-US">Copyright (c) 2022 Lie Khie Chen</dc:rights>
</oai_dc:dc>