Article type
Year
Abstract
Background:
The outbreak of COVID-19 is the third introduction of a highly pathogenic coronavirus into the human population in the twenty-first century, after the Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS) epidemics. At present, there are no standardized or specific treatment schemes for COVID-19 patients, and the clinical treatment mainly focuses on symptomatic and supportive care.
Objectives:
The aim of this review was to evaluate the efficacy and safety of antibiotic agents in children with COVID-19, as well as to introduce the present situation of antibiotics use and bacterial coinfections in COVID-19 patients.
Methods:
We searched Cochrane library, MEDLINE, Embase, Web of Science, CBM, Wanfang Data and CNKI from their inception to February 29, 2020. In addition, we searched related studies on COVID-19 published before February 29, 2020 through Google Scholar and preprint servers. We evaluated the risk of bias of included studies, and synthesized the results using a qualitative synthesis.
Results:
Five case series and one cohort study met our inclusion criteria. Five studies on SARS showed an overall risk of death of 7.2% to 20.0%. One study of SARS patients who used macrolides, quinolones or beta lactamases showed that the mean duration of hospital stay was 14.2, 13.8 and 16.2 days respectively, and their average duration of fever was 14.3, 14.0 and 16.2 days. One cohort study on MERS indicated that macrolide therapy was not associated with a significant reduction in 90-day mortality (OR=0.84, 95% CI [0.47, 1.51], P = 0.56) and improvement in MERS-CoV RNA clearance (HR=0.88, 95% CI [0.47, 1.64], P = 0.68). Besides, 24 studies testified that the proportion of antibiotics use ranged from 16.0% to 19.4% in children and 12.4% to 100% in adults. The most commonly used antibiotic in adults was quinolones and in children were cephalosporins and macrolides, despite the lack of etiological evidence.
Conclusions:
The benefits of antibiotic agents for adults infected with SARS or MERS were questionable in the absence of bacterial coinfections. There is no evidence to support the use of antibiotic agents for children with COVID-19 in the absence of bacterial coinfection.
Patient or healthcare consumer involvement:
None
The outbreak of COVID-19 is the third introduction of a highly pathogenic coronavirus into the human population in the twenty-first century, after the Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS) epidemics. At present, there are no standardized or specific treatment schemes for COVID-19 patients, and the clinical treatment mainly focuses on symptomatic and supportive care.
Objectives:
The aim of this review was to evaluate the efficacy and safety of antibiotic agents in children with COVID-19, as well as to introduce the present situation of antibiotics use and bacterial coinfections in COVID-19 patients.
Methods:
We searched Cochrane library, MEDLINE, Embase, Web of Science, CBM, Wanfang Data and CNKI from their inception to February 29, 2020. In addition, we searched related studies on COVID-19 published before February 29, 2020 through Google Scholar and preprint servers. We evaluated the risk of bias of included studies, and synthesized the results using a qualitative synthesis.
Results:
Five case series and one cohort study met our inclusion criteria. Five studies on SARS showed an overall risk of death of 7.2% to 20.0%. One study of SARS patients who used macrolides, quinolones or beta lactamases showed that the mean duration of hospital stay was 14.2, 13.8 and 16.2 days respectively, and their average duration of fever was 14.3, 14.0 and 16.2 days. One cohort study on MERS indicated that macrolide therapy was not associated with a significant reduction in 90-day mortality (OR=0.84, 95% CI [0.47, 1.51], P = 0.56) and improvement in MERS-CoV RNA clearance (HR=0.88, 95% CI [0.47, 1.64], P = 0.68). Besides, 24 studies testified that the proportion of antibiotics use ranged from 16.0% to 19.4% in children and 12.4% to 100% in adults. The most commonly used antibiotic in adults was quinolones and in children were cephalosporins and macrolides, despite the lack of etiological evidence.
Conclusions:
The benefits of antibiotic agents for adults infected with SARS or MERS were questionable in the absence of bacterial coinfections. There is no evidence to support the use of antibiotic agents for children with COVID-19 in the absence of bacterial coinfection.
Patient or healthcare consumer involvement:
None