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Evaluation of Antimicrobial Drug Use and Concurrent Infections During Hospitalization of Patients With COVID-19 in Japan

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

A recent meta-analysis1,2 and a prospective study3 reported that bacterial coinfection and secondary infection among patients with COVID-19 infection are uncommon. However, in these studies, antimicrobial drugs were prescribed for approximately 70% of patients with the disease.2 Therefore, data are needed on patients with COVID-19 infection who do not routinely receive an antimicrobial drug prescription, to identify the true rate of concurrent infection in this patient population. At the National Hospital Organization Tochigi Medical Center in Utsunomiya, Tochigi, Japan, since the beginning of the COVID-19 pandemic, antimicrobial drugs have not been prescribed for patients with COVID-19 infection unless their symptoms are suggestive of another infectious disease. Therefore, we investigated the prevalence of antimicrobial drug use and concurrent infections among patients with COVID-19 during hospitalization.

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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

Article Information

Accepted for Publication: December 30, 2021.

Published: February 18, 2022. doi:10.1001/jamanetworkopen.2022.0040

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2022 Komagamine J et al. JAMA Network Open.

Corresponding Author: Junpei Komagamine, MD, Department of Internal Medicine, National Hospital Organization Tochigi Medical Center, 1-10-37 Nakatomatsuri, Utsunomiya, Tochigi, Japan (junpei0919@yahoo.co.jp).

Author Contributions: Dr Komagamine had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Komagamine, Yabuki.

Acquisition, analysis, or interpretation of data: Komagamine, Matsumoto, Tanaka.

Drafting of the manuscript: Komagamine.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Komagamine.

Supervision: Komagamine, Yabuki.

Conflict of Interest Disclosures: None reported.

Meeting Presentation: Data from this study will be used at a poster presentation at the 119th Annual Meeting of the Japanese Society of Internal Medicine, April 15-17, 2022; virtual.

References
1.
Langford  BJ , So  M , Raybardhan  S ,  et al.  Bacterial co-infection and secondary infection in patients with COVID-19: a living rapid review and meta-analysis.   Clin Microbiol Infect. 2020;26(12):1622-1629. doi:10.1016/j.cmi.2020.07.016 PubMedGoogle ScholarCrossref
2.
Langford  BJ , So  M , Raybardhan  S ,  et al.  Antibiotic prescribing in patients with COVID-19: rapid review and meta-analysis.   Clin Microbiol Infect. 2021;27(4):520-531. doi:10.1016/j.cmi.2020.12.018 PubMedGoogle ScholarCrossref
3.
Russell  CD , Fairfield  CJ , Drake  TM ,  et al; ISARIC4C investigators.  Co-infections, secondary infections, and antimicrobial use in patients hospitalised with COVID-19 during the first pandemic wave from the ISARIC WHO CCP-UK study: a multicentre, prospective cohort study.   Lancet Microbe. 2021;2(8):e354-e365. doi:10.1016/S2666-5247(21)00090-2 PubMedGoogle ScholarCrossref
4.
Agarwal  A , Rochwerg  B , Siemieniuk  RA ,  et al.  A living WHO guideline on drugs for covid-19.   BMJ. 2020;370:m3379. doi:10.1136/bmj.m3379 PubMedGoogle Scholar
5.
World Health Organization. Clinical management of COVID-19 patients: living guidance. Accessed October 18, 2021. https://apps.who.int/iris/bitstream/handle/10665/338882/WHO-2019-nCoV-clinical-2021.1-eng.pdf
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