ArticlePloS one2021
Inappropriate antibiotic use in the COVID-19 era: Factors associated with inappropriate prescribing and secondary complications. Analysis of the registry SEMI-COVID.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 64 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
64 citing papers in PubMed, 2 syntheses or guidelines pooled it, 116 citations in OpenAlex.
- Epidemiology and Pathophysiology of COVID-19-Associated Mucormycosis: India Versus the Rest of the World.Mycopathologia · 2021Pooled it
- COVID-19-associated mucormycosis: Case report and systematic review.Travel medicine and infectious diseasePooled it
- Antibiotic Use, Bacterial Co-Infection, and Antimicrobial Resistance in Adults Hospitalized with COVID-19, Influenza, or RSV: A Systematic Review and Meta-Analysis.Antibiotics (Basel, Switzerland) · 2026Review
- Paleopathology Meets Public Health: Deep-Time Syndemics and the Ecology of Emerging Infections.Pathogens (Basel, Switzerland) · 2026Review
- Factors associated with antibiotic prescription among patients with respiratory illness in Thailand: The potential impact of rapid influenza diagnostic testing in antimicrobial stewardship.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2026Article
- When good knowledge falls short: identity and geography drive inappropriate antibiotic use in Malaysia.BMC public health · 2026Article
- Infection point of care tests bridge the experience gap of antibiotic STOP decisions: clinicians versus students.The Journal of antimicrobial chemotherapy · 2026Observational
- From Widespread Use to Loss of Effectiveness: The Consequences of Inappropriate Azithromycin Prescriptions During the COVID-19 Pandemic-A Systematic Review and Meta-Analysis.International journal of microbiology · 2026Review
- High frequency of antibiotic administration for COVID-19 patients in Syria and its associations with mortality and complications.BMC infectious diseases · 2025Observational
- Comparative Safety of Empirical Antibiotic Classes in Newly Hospitalized COVID-19 Patients.Pharmaceuticals (Basel, Switzerland) · 2025Article
- Impact of the COVID-19 Pandemic on Carbapenem-ResistantAntibiotics (Basel, Switzerland) · 2025Article
- A Retrospective Study of the Impact of the COVID-19 Pandemic on the Utilization and Quality of Antibiotic Use in a Tertiary Care Teaching Hospital in Low-Resource Settings.Antibiotics (Basel, Switzerland) · 2025Article
- Public knowledge, attitudes, and practices regarding antibiotics use and resistance in Montenegro.European journal of public health · 2025Article
- The impact of health and technology shifts on antibiotic use among the elderly in Thailand.Scientific reports · 2025Article
- Seasonal variations and the COVID-19 pandemic: impact on antimicrobial stewardship and antibiotic prescribing in a UK secondary care setting to combat antimicrobial resistance-a pilot study.Frontiers in microbiology · 2025Article
- Patterns of In-patient Antibiotic Use among COVID-19 Patients in a Tertiary Government Hospital: A Retrospective Cross-sectional Survey.Acta medica Philippina · 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
- Article
- 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
4 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
26 authors at 17 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMost patients with COVID-19 receive antibiotics despite the fact that bacterial co-infections are rare. This can lead to increased complications, including antibacterial resistance. We aim to analyze risk factors for inappropriate antibiotic prescription in these patients and describe possible complications arising from their use.
methodsThe SEMI-COVID-19 Registry is a multicenter, retrospective patient cohort. Patients with antibiotic were divided into two groups according to appropriate or inappropriate prescription, depending on whether the patient fulfill any criteria for its use. Comparison was made by means of multilevel logistic regression analysis. Possible complications of antibiotic use were also identified.
resultsOut of 13,932 patients, 3047 (21.6%) were prescribed no antibiotics, 6116 (43.9%) were appropriately prescribed antibiotics, and 4769 (34.2%) were inappropriately prescribed antibiotics. The following were independent factors of inappropriate prescription: February-March 2020 admission (OR 1.54, 95%CI 1.18-2.00), age (OR 0.98, 95%CI 0.97-0.99), absence of comorbidity (OR 1.43, 95%CI 1.05-1.94), dry cough (OR 2.51, 95%CI 1.94-3.26), fever (OR 1.33, 95%CI 1.13-1.56), dyspnea (OR 1.31, 95%CI 1.04-1.69), flu-like symptoms (OR 2.70, 95%CI 1.75-4.17), and elevated C-reactive protein levels (OR 1.01 for each mg/L increase, 95% CI 1.00-1.01). Adverse drug reactions were more frequent in patients who received ANTIBIOTIC (4.9% vs 2.7%, p < .001).
conclusionThe inappropriate use of antibiotics was very frequent in COVID-19 patients and entailed an increased risk of adverse reactions. It is crucial to define criteria for their use in these patients. Knowledge of the factors associated with inappropriate prescribing can be helpful.
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