Evidence map›Paper›PMID 40569348›Full record

ArticleInfection2025

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

Anette Friedrichs, Roman Wenz, Daniel Pape, Katharina S Appel, Thomas Bahmer, Karsten Becker, Sven Bercker, Sabine Blaschke, Josephine Braunsteiner, Jana Butzmann and 33 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Infection, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

43 authors.

Anette Friedrichs *Department of Internal Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany. anette.friedrichs@uksh.de.
Roman Wenz *Institute of Medical Informatics and Statisitics, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.
Daniel PapeDepartment of Internal Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.
Katharina S AppelInstitute for Digital Medicine and Clinical Data Science, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.
Thomas BahmerDepartment of Internal Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.
Karsten BeckerFriedrich Loeffler-Institute of Medical Microbiology, University Medicine Greifswald, Greifswald, Germany.
Sven BerckerUniversity Hospital Leipzig, Leipzig, Germany.
Sabine BlaschkeEmergency Department, University Medical Center Goettingen, Göttingen, Germany.
Josephine BraunsteinerDepartment of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Jana ButzmannInstitute of Medical Microbiology and Hospital Hygiene, University Hospital Magdeburg, Magdeburg, Germany.
Egdar DahlInstitute of Pathology, University Hospital Aachen, Aachen, Germany.
Johanna ErberTUM School of Medicine, Clinical Department for Internal Medicine II, University Hospital rechts der Isar, Technical University of Munich, Munich, Germany.
Lisa FrickeTUM School of Medicine, Clinical Department for Internal Medicine II, University Hospital rechts der Isar, Technical University of Munich, Munich, Germany.
Ramsia GeislerInstitute for Digital Medicine and Clinical Data Science, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.
Siri GöpelDivision of Infectious Diseases, Department of Internal Medicine I, University Hospital Tübingen, Tübingen, Germany.
Andreas GüldnerDepartment of Anesthesiology and Intensive Care Medicine, University Hospital "Carl Gustav Carus", Technische Universität Dresden, Dresden, Germany.
Marina HagenDepartment II of Internal Medicine, Hematology/Oncology, Goethe University, Frankfurt am Main, Germany.
Axel HamprechtInstitute for Medical Microbiology and Virology, University Medicine Oldenburg, Oldenburg, Germany.
Stefan HanschDepartment for Infectious Diseases and Infection Control, University Hospital Regensburg, Regensburg, Germany.
Peter U HeuschmannInstitute for Clinical Epidemiology and Biometry, University of Wurzburg, Würzburg, Germany.
Sina M PützDepartment I for Internal Medicine, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany.
Björn-Erik Ole JensenDepartment of Gastroenterology, Hepatology and Infectious Diseases, Düsseldorf University Hospital, Düsseldorf, Germany.
Nadja KädingInfectious Diseases Clinic, University of Schleswig -Holstein, Campus Lübeck, Lübeck, Germany.
Julia KoepsellDepartment II of Internal Medicine, Hematology/Oncology, Goethe University, Frankfurt am Main, Germany.
Carolin E M KollDepartment I for Internal Medicine, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany.
Marcin KrawczykDepartment of Medicine II, Saarland University Medical Center, Saarland University, Homburg, Germany.
Thomas LückeDepartment of Pediatrics, Ruhr University, Bochum, Germany.
Patrick MeybohmDepartment of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Würzburg, Würzburg, Germany.
Milena MilovanovicDepartement I of Internal Medicine, Malteser Clinic St. Franziskus Hospital, Flensburg, Germany.
Lazar MitrovDepartment I for Internal Medicine, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany.
Carolin NürnbergerInstitute for Clinical Epidemiology and Biometry, University of Wurzburg, Würzburg, Germany.
Christoph RömmeleGastroenterology and Infectious diseases, Faculty of Medicine, University Hospital of Augsburg, Augsburg, Germany.
Margarete SchererInstitute for Digital Medicine and Clinical Data Science, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.
Lena SchmidbauerInstitute for Clinical Epidemiology and Biometry, University of Wurzburg, Würzburg, Germany.
Melanie StecherDepartment I for Internal Medicine, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany.
Phil-Robin TepasseDepartment of Medicine B for Gastroenterology, Hepatology, Endocrinology and Clinical Infectiology, University Hospital Münster, Münster, Germany.
Andreas TeufelDivision of Hepatology, Department of Medicine II, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Jörg Janne VehreschildInstitute for Digital Medicine and Clinical Data Science, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.
Christof WinterTUM School of Medicine, Institute for Clinical Chemistry and Pathobiochemistry, University Hospital rechts der Isar, Technical University of Munich, Munich, Germany.
Oliver WitzkeDepartment of Infectious Diseases, West German Centre of Infectious Diseases, University Medicine Essen University Hospital Essen, University Duisburg-Essen, Essen, Germany.
Christoph WyenDepartment I for Internal Medicine, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany.
Frank HansesDepartment for Infectious Diseases and Infection Control, University Hospital Regensburg, Regensburg, Germany.
Amke CaliebeInstitute of Medical Informatics and Statisitics, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe 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.

methodsBetween 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.

resultsA 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.

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

Indexed as

Anti-Bacterial AgentsCOVID-19COVID-19 Drug TreatmentAdultAgedAged, 80 and overFemaleGermanyHospitalizationHumansMaleMiddle AgedProspective StudiesSARS-CoV-2Severity of Illness IndexTreatment OutcomeAnti-Bacterial AgentsClinical improvementClinical outcomeCOVID-19Moderate diseaseRational antibiotic therapy

Identifiers

PMID40569348
PMCPMC12675722

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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.