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COVID-19

Antibiotic Overuse in Children Hospitalized with COVID-19: A Growing Concern

Strategic Insights

— 1 min read

A study published in BMC Pediatrics has shed light on the issue of antibiotic overuse in children hospitalized with viral lower respiratory tract infections (LRTIs), including COVID-19. The research, conducted at Vanderbilt University Medical Center, found that children hospitalized with community-onset viral LRTIs are often prescribed antibiotics due to concern for bacterial co-infection, despite most not having concurrent bacterial infections. This unnecessary antibiotic treatment can lead to bacterial resistance and adverse events, highlighting the need for improved antibiotic stewardship in this population.

Key Takeaways:

  • The study found that 60.6% of children hospitalized with influenza, 41.2% with RSV, and 48.6% with COVID-19 received antibiotics, despite only 8% having culture-confirmed bacterial co-infection.
  • Patients with RSV were younger and more likely to be in intensive care, highlighting the need for targeted interventions.
  • Predictors of antibiotic treatment included elevated inflammatory markers, comorbidities, mechanical ventilation, intensive care unit admission, influenza infection, and a concurrent non-respiratory infection.
  • The study suggests that antibiotic overuse is a significant issue in children hospitalized with community-onset viral LRTIs, particularly for influenza.
  • The research highlights the importance of improved antibiotic stewardship in pediatric populations, including the use of evidence-based treatment guidelines and the implementation of antibiotic stewardship programs.
  • The authors suggest that clinicians should be cautious when prescribing antibiotics to children hospitalized with viral LRTIs and should consider alternative treatments, such as supportive care.
  • The study's findings have implications for pediatricians, infectious disease specialists, and policymakers working to improve antibiotic use and reduce antibiotic resistance.

Statistics:

  • 1,718 patients were included in the study, with 188 hospitalized with influenza, 1,022 with RSV, and 535 with COVID-19.
  • 60.6% of children hospitalized with influenza received antibiotics, compared to 41.2% with RSV and 48.6% with COVID-19.
  • Only 8% of patients had culture-confirmed bacterial co-infection, despite high rates of antibiotic treatment.
  • Antibiotic treatment was associated with elevated inflammatory markers, comorbidities, mechanical ventilation, intensive care unit admission, influenza infection, and a concurrent non-respiratory infection.
  • The study found a statistically significant difference in antibiotic treatment rates among viruses, with influenza having the highest rate (p < 0.001).

Sources:

  • Antibiotic overuse in a contemporary cohort of children hospitalized with influenza, RSV, or SARS-CoV-2: a retrospective cohort study. BMC Pediatrics, 2025;25(1):759.
  • BioMed Central. www.biomedcentral.com/
  • Vanderbilt University Medical Center. Nashville, TN, United States.

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