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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
Published
2022-07-07
Publisher
The Indonesian Society of Internal Medicine
Language
eng

Abstract

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.

Keywords

Collaboration network of the authors

40 authors · 157 co-authorship links · showing the 40 most connected

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Co-authorOrganisationJoint articles
Erni Juwita NelwanAffiliation unknown16
Cleopas Martin RumendeAffiliation unknown8
Ikhwan RinaldiAffiliation unknown7
Randy AdiwinataAffiliation unknown5
Hamzah ShatriAffiliation unknown5
Erni J NelwanAffiliation unknown4
Suryo Anggoro Kusumo WibowoAffiliation unknown4
Adeline Intan PasaribuAffiliation unknown3
Samuel Theodorus SutantoAffiliation unknown3
Suhendro SuhendroAffiliation unknown2
Noto DwimartutieAffiliation unknown2
Djoko WidodoAffiliation unknown2
Irsan HasanAffiliation unknown2
Cleopas M RumendeAffiliation unknown1
Eppy EppyAffiliation unknown1
Evi IndrasantiAffiliation unknown1
Farida NurchaidaAffiliation unknown1
Rustadi SosrosumihardjoAffiliation unknown1
Andi KristantoAffiliation unknown1
Silvia SumintoAffiliation unknown1
Benny N KurniawanAffiliation unknown1
Finna ChristiantyAffiliation unknown1
Suhendro SuwartoAffiliation unknown1
Esthika DewiastyAffiliation unknown1
Candra WigunaAffiliation unknown1
Helio GuterresAffiliation unknown1
Ralalicia LimatoAffiliation unknown1
Muhadi MuhadiAffiliation unknown1
Pringgodigdo NugrohoAffiliation unknown1
Kresna Dharma SuryanaAffiliation unknown1
Adityo SusiloAffiliation unknown1
Beryl AlodiaAffiliation unknown1
Rahajeng N TunjungputriAffiliation unknown1
Erpryta N TetrasiwiAffiliation unknown1
Richella K LaudittaAffiliation unknown1

Affiliations come from OpenAlex; journal OAI-PMH metadata carries none. Authors without an OpenAlex ID are matched by name, which can merge or split people.

Metadata source: OAI-PMH (metadata jurnal) http://www.actamedindones.org/index.php/ijim/oai, first harvested 8 Nov 2026, last seen 8 Nov 2026.
Original metadata (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>