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Purpose <p>The benefit of antibiotic treatment (ABT) for patients with moderate COVID-19 is unclear and overtreatment poses the risk of adverse effects such as <i>Clostridioides difficile</i> infection and antibiotic resistance. This multi-center study compares health status improvement between patients with and without ABT at hospital admission.</p> Methods <p>Between March 2020 and May 2023, hospitalized adults with confirmed SARS-CoV-2 infection were recruited from the German National Pandemic Cohort Network (NAPKON), which includes patients from various hospitals across Germany. The study population included patients with moderate or severe COVID-19 at baseline. The primary objective was to compare health improvement or decline after two weeks between patients who received ABT at baseline and those who did not in the moderate COVID-19 population. The statistical analysis adjusted for confounders such as gender, age, vaccination status, clinical condition, and comorbidities. The severe COVID-19 population was investigated as a secondary objective.</p> Results <p>A total of 1,317 patients (median age 59&#xa0;years; 38% women) were eligible for analysis, of whom 1,149 had moderate and 168 severe COVID-19 disease. ABT for pneumonia was administered to 467 patients with moderate and 117 with severe COVID-19. ABT at baseline was significantly associated with a higher deterioration rate after two weeks in patients with moderate COVID-19 (ABT: 292 improvement, 61 deterioration; no ABT: 429 improvement, 14 deterioration). A similar result was obtained in the multiple regression analysis where an odds ratio of 5.00 (95% confidence interval: 2.50 – 10.93) for ABT was observed.</p> Conclusion <p>We found no benefit of antibiotic therapy in patients with moderate COVID-19. Use of ABT was associated with a higher likelihood of clinical deterioration.</p> Graphical abstract <p></p>

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The effect of antibiotic therapy on clinical outcome in patients hospitalized with moderate COVID-19 disease: a prospective multi-center cohort study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年6月26日

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  • Anette Friedrichs,
  • Roman Wenz,
  • Daniel Pape,
  • Katharina S. Appel,
  • Thomas Bahmer,
  • Karsten Becker,
  • Sven Bercker,
  • Sabine Blaschke,
  • Josephine Braunsteiner,
  • Jana Butzmann,
  • Egdar Dahl,
  • Johanna Erber,
  • Lisa Fricke,
  • Ramsia Geisler,
  • Siri Göpel,
  • Andreas Güldner,
  • Marina Hagen,
  • Axel Hamprecht,
  • Stefan Hansch,
  • Peter U. Heuschmann,
  • Sina M. Pütz,
  • Björn-Erik Ole Jensen,
  • Nadja Käding,
  • Julia Koepsell,
  • Carolin E. M. Koll,
  • Marcin Krawczyk,
  • Thomas Lücke,
  • Patrick Meybohm,
  • Milena Milovanovic,
  • Lazar Mitrov,
  • Carolin Nürnberger,
  • Christoph Römmele,
  • Margarete Scherer,
  • Lena Schmidbauer,
  • Melanie Stecher,
  • Phil-Robin Tepasse,
  • Andreas Teufel,
  • Jörg Janne Vehreschild,
  • Christof Winter,
  • Oliver Witzke,
  • Christoph Wyen,
  • Frank Hanses,
  • Amke Caliebe

摘要

Purpose

The benefit of antibiotic treatment (ABT) for patients with moderate COVID-19 is unclear and overtreatment poses the risk of adverse effects such as Clostridioides difficile infection and antibiotic resistance. This multi-center study compares health status improvement between patients with and without ABT at hospital admission.

Methods

Between March 2020 and May 2023, hospitalized adults with confirmed SARS-CoV-2 infection were recruited from the German National Pandemic Cohort Network (NAPKON), which includes patients from various hospitals across Germany. The study population included patients with moderate or severe COVID-19 at baseline. The primary objective was to compare health improvement or decline after two weeks between patients who received ABT at baseline and those who did not in the moderate COVID-19 population. The statistical analysis adjusted for confounders such as gender, age, vaccination status, clinical condition, and comorbidities. The severe COVID-19 population was investigated as a secondary objective.

Results

A total of 1,317 patients (median age 59 years; 38% women) were eligible for analysis, of whom 1,149 had moderate and 168 severe COVID-19 disease. ABT for pneumonia was administered to 467 patients with moderate and 117 with severe COVID-19. ABT at baseline was significantly associated with a higher deterioration rate after two weeks in patients with moderate COVID-19 (ABT: 292 improvement, 61 deterioration; no ABT: 429 improvement, 14 deterioration). A similar result was obtained in the multiple regression analysis where an odds ratio of 5.00 (95% confidence interval: 2.50 – 10.93) for ABT was observed.

Conclusion

We found no benefit of antibiotic therapy in patients with moderate COVID-19. Use of ABT was associated with a higher likelihood of clinical deterioration.

Graphical abstract