Children hospitalized with COVID-19 infection are frequently prescribed unnecessary antibiotic therapy despite a low rate of culture-confirmed bacterial coinfection, according to study results presented at IDWeek 2022, held from October 19 to 23, in Washington, DC.
Researchers conducted a single-center retrospective cohort study among children admitted to a pediatric intensive care unit (ICU) at a tertiary care children’s hospital between May 2020 and February 2022. A total of 91 patients with symptomatic COVID-19 infection were included in the analysis. The researchers sought to quantify rates of bacterial infections and antibiotic use.
Among patients included in the analysis, the median age was 12.4 years, 45% were boys, 14% Hispanic, and the median length of hospitalization was 6 (range, 1-94) days. In addition, 32% of patients required mechanical ventilation, 79% had comorbid conditions, and 1 patient was fully vaccinated against COVID-19 infection.
Bacterial culture growth was reported in 13 (14%) patients, and 5 (5%) had urinary tract or bloodstream infections. The researchers noted hospital-acquired disease and antimicrobial-resistant organisms among 2 of the patients with bloodstream infections.
Although most children (range, 5%-14%) did not have culture-confirmed bacterial infection, 45% received antibiotic treatment for more than 3 days. The duration of antibiotic treatment varied significantly among the patients, ranging from 0 to 61 days.
Limitations of this study include the retrospective and single-center design.
“Despite these limitations, this work suggests that children with COVID-19 rarely have bacterial co-infections and are often prescribed unnecessary antibiotics,” the researchers concluded.
Gillon J, Garguilo K, LeBlanc K, Banerjee R. Antibiotic overuse among children with COVID-19 hospitalized in a pediatric intensive care unit. Presented at: IDWeek 2022; October 19-23; Washington, DC. Poster 240.