GuidelineClinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases2021
Recommendations for antibacterial therapy in adults with COVID-19 - an evidence based guideline.
Guideline in Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 105 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
105 citing papers in PubMed, 2 syntheses or guidelines pooled it, 206 citations in OpenAlex.
- Antimicrobial resistance (AMR) in COVID-19 patients: a systematic review and meta-analysis (November 2019-June 2021).Antimicrobial resistance and infection control · 2022Pooled it
- International alliance and AGREE-ment of 71 clinical practice guidelines on the management of critical care patients with COVID-19: a living systematic review.Journal of clinical epidemiology · 2022Pooled it
- Efficacy and safety of antimicrobial stewardship prospective audit and feedback in patients hospitalised with COVID-19 (COVASP): a pragmatic, cluster-randomised, non-inferiority trial.The Lancet. Infectious diseases · 2023Trial
- Risk factors and outcomes of secondary co-infections in hospitalised COVID-19 patients in Malaysia: a case control study.BMC microbiology · 2026Article
- Patterns of Antibiotic Use in Hospitalized COVID-19 Patients and Association with Secondary Infections and Outcomes.Antibiotics (Basel, Switzerland) · 2026Article
- Procalcitonin-guided antibiotic prescription in patients with respiratory syncytial virus and influenza virus.BMJ open respiratory research · 2025Article
- Comparative Safety of Empirical Antibiotic Classes in Newly Hospitalized COVID-19 Patients.Pharmaceuticals (Basel, Switzerland) · 2025Article
- The burden of nosocomial superinfections in a retrospective cohort study of critically ill COVID-19 patients.BMC infectious diseases · 2025Article
- Initial Empirical Antibiotic Treatment in Patients with COVID-19 is Associated with Excess Adverse Drug Reactions without Clinical Benefit.Turkish journal of pharmaceutical sciences · 2025Article
- Use of antibiotics in the early COVID-19 pandemic in Poland, the Netherlands and Spain, from erraticism to (more) logic.European journal of clinical pharmacology · 2024Article
- To prescribe or not: a two-center retrospective observational study of antibiotics usage and outcomes of COVID-19 in Turkey.Scientific reports · 2024Observational
- Timing and prediction of secondary bacteremia in patients with COVID-19: A retrospective cohort study.Journal of general and family medicine · 2024Article
- Disruption of hospital care during the first year of the COVID-19 pandemic impacted socioeconomic groups differently: population based study using routine registration data.BMC health services research · 2024Article
- Early empiric antibiotic use in COVID-19 patients: results from the international VIRUS registry.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2024Article
- Risk factors, outcomes, and epidemiological and etiological study of hospitalized COVID-19 patients with bacterial co-infection and secondary infections.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2024Article
- Antimicrobial prescribing practices and factors associated with antimicrobial prescribing in hospitalized COVID-19 patients in Oyo state: A retrospective study.PLOS global public health · 2024Article
- The Impact of Early Antibiotic Use on Clinical Outcomes of Patients Hospitalized with COVID-19: A Propensity Score-Matched Analysis.Infection and drug resistance · 2024Article
- [Bacterial coinfection in the critically-ill COVID-19 patient: incidence, impact and need for antimicrobial therapy].Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2023Article
- Antibiotic prescribing guideline recommendations in COVID-19: a systematic survey.EClinicalMedicine · 2023Article
- Observational
45 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors at 10 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
scopeThe Dutch Working Party on Antibiotic Policy constituted a multidisciplinary expert committee to provide evidence-based recommendation for the use of antibacterial therapy in hospitalized adults with a respiratory infection and suspected or proven 2019 Coronavirus disease (COVID-19).
methodsWe performed a literature search to answer four key questions. The committee graded the evidence and developed recommendations by using Grading of Recommendations Assessment, Development, and Evaluation methodology. QUESTIONS ADDRESSED BY THE GUIDELINE AND RECOMMENDATIONS: We assessed evidence on the risk of bacterial infections in hospitalized COVID-19 patients, the associated bacterial pathogens, how to diagnose bacterial infections and how to treat bacterial infections. Bacterial co-infection upon admission was reported in 3.5% of COVID-19 patients, while bacterial secondary infections during hospitalization occurred up to 15%. No or very low quality evidence was found to answer the other key clinical questions. Although the evidence base on bacterial infections in COVID-19 is currently limited, available evidence supports restrictive antibiotic use from an antibiotic stewardship perspective, especially upon admission. To support restrictive antibiotic use, maximum efforts should be undertaken to obtain sputum and blood culture samples as well as pneumococcal urinary antigen testing. We suggest to stop antibiotics in patients who started antibiotic treatment upon admission when representative cultures as well as urinary antigen tests show no signs of involvement of bacterial pathogens after 48 hours. For patients with secondary bacterial respiratory infection we recommend to follow other guideline recommendations on antibacterial treatment for patients with hospital-acquired and ventilator-associated pneumonia. An antibiotic treatment duration of five days in patients with COVID-19 and suspected bacterial respiratory infection is recommended upon improvement of signs, symptoms and inflammatory markers. Larger, prospective studies about the epidemiology of bacterial infections in COVID-19 are urgently needed to confirm our conclusions and ultimately prevent unnecessary antibiotic use during the COVID-19 pandemic.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.