Multiplex PCR in the empirical antibiotic treatment of patients with SARS-CoV-2 and bacterial respiratory superinfection

• DOI: 10.1016/j.infpip.2022.100227
• Publication Date: 2022-06-28T20:53:52Z
• Authors: V. Paz; M.L. D'Agostino; F. Garibaldi; R. Orellana; M. Paniagua; A. Santillán
• Keywords: Superinfection; 2019-20 coronavirus outbreak

The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic led to overuse of antimicrobials, which increased concerns regarding antimicrobial resistance.To measure the impact a multiplex polymerase chain reaction (PCR) pneumonia panel on empirical antibiotic treatment for patients with critical coronavirus disease 2019 (COVID-19) suspected bacterial superinfection.This descriptive, prospective study was undertaken in 36-bed intensive care unit from June 2020 July 2021. Patients COVID-19 who were ventilated and under suspicion superinfection included study. intervention semi-quantitative PCR alongside concurrent standard cultures. When results expected be obtained within 3 h sampling, not administered while awaiting results. Otherwise, initiated. classified as 'avoided treatment' avoided 48-72 therapy. For those received treatment, used decide whether should escalated, de-escalated, maintained or stopped. Positive negative predictive values, calculated. Medical conduct analysed treatment.Eighty-two (71% male, 29% female) this mean age 57.5 years, APACHE II score 16. Ninety panels performed, positive values 99.9% 66.7%, respectively. Empirical 61% episodes. Of receiving antibiotics when de-escalated 71%, escalated 14%, stopped 9% 6%. A diagnosis ruled out 19% cases.PCR prevented initiation two-thirds patients, de-escalation more than had started treatment. high value allowed out. This tool represents significant contribution diagnostic stewardship order avoid unnecessary use antibiotics.