antibioticsАнтибиотики и ХимиотерапияAntibiot Khimioter = Antibiotics and Chemotherapy0235-2990ООО «Издательство ОКИ»10.37489/0235-2990-2022-67-11-12-64-78antibiotics-983Research ArticleОБЗОРЫREVIEWSСуществует ли необходимость в широком назначении антибиотиков пациентам с COVID-19?Is There a Need to Widely Prescribe Antibiotics in Patients with COVID-19?https://orcid.org/0000-0002-7464-826XКаролиН. А.KaroliN. A.

Кароли Нина Анатольевна — доктор медицинских наук, профессор кафедры госпитальной терапии лечебного факультета.

ул. Б. Казачья, 112, Саратов, 410012

ResearcherID: W-8077-2019

Scopus  Author ID: 6603194518

Nina A. Karoli — D. Sc. in Medicine, Professor at the Hospital Therapy Department, Saratov State Medical University named after V.I. Razumovsky of the Ministry of Health of the Russian Federation.

112 B. Kazachya st., Saratov, 410012

ResearcherID: W-8077-2019

Scopus  Author ID: 6603194518

nina.karoli.73@gmail.comhttps://orcid.org/0000-0002-3463-7734РебровА. П.RebrovA. P.

Ребров Андрей Петрович — доктор медицинских наук, профессор, заведующий кафедрой госпитальной терапии лечебного факультета.

ул. Б. Казачья, 112, Саратов, 410012

ResearcherID: AAD-7684-2021

Scopus  ID: 7005047527

Andrey P. Rebrov — D. Sc. in Medicine, Professor, Head of Hospital Therapy Department of Saratov State Medical University named  after V.I. Razumovsky  of the Ministry of Health  of the Russian Federation.

112 B. Kazachya st., Saratov, 410012

ResearcherID: AAD-7684-2021

Scopus  ID: 7005047527

Саратовский ГМУ им. В.И. Разумовского Минздрава РоссииРоссияSaratov State Medical University named after V.I. Razumovsky of the Ministry of Health of the Russian FederationRussian Federation2022100220236711-126478Copyright © Кароли Н.А., Ребров А.П., 20232023Кароли Н.А., Ребров А.П.Karoli N.A., Rebrov A.P.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.antibiotics-chemotherapy.ru/jour/article/view/983

Последние два года пандемия SARS-CoV-2 доминировала во всех аспектах здравоохранения во всем мире, оставляя нередко другие долгосрочные  общественные  проблемы  со здоровьем в тени. Несмотря  на то, что COVID-19 является вирусным  заболеванием, применение  антибиотиков (АБ) у этих пациентов было обычной практикой, особенно в начале пандемии. Использование АБ у больных новой короновирусной  инфекцией (НКИ) достигает более 70% случаев. Подозрение на сопутствующую бактериальную инфекцию, отсутствие эффективных средств лечения НКИ, терминологические проблемы, связанные  с определением «пневмония», возможно, были мотивирующим фактором  такого широкого  использования. Данные  проведённых  исследований  свидетельствуют, что в настоящее время недостаточно доказательств для широкого эмпирического использования антибиотиков у большинства госпитализированных больных, так как общая доля бактериальных инфекций при COVID-19 достаточно низкая. Так, по данным большинства исследователей, сочетанная  бактериальная  инфекция встречается редко и составляет  менее 10%. Необоснованное назначение  антибиотиков  пациентам  с COVID-19 может привести к осложнениям, которых можно избежать, включая повышенную бактериальную резистентность, инфекцию Clostridioides  difficile, почечную  недостаточность  и многое другое. В статье представлена информация о частоте АБ терапии на различных этапах оказания медицинской помощи. Проведён анализ данных о характере антибиотиков,  назначаемых  у госпитализированных и амбулаторных пациентов с COVID-19 в разных странах. Представлены рекомендации разных стран по АБ терапии у больных COVID-19. Заключение. Рассмотренные данные подтверждают несоответствие между необоснованным и чрезмерным назначением антибиотиков пациентам с COVID-19 и малочисленностью доказательств ассоциированных бактериальных инфекций.

Over the past two years, the SARS-CoV-2 pandemic has dominated all aspects of health care around the world, often leaving other long-term public health problems in the background. Despite the fact that COVID-19 is a viral disease, the use of antibiotics in these patients was common practice, especially at the beginning of the pandemic. The use of antibiotics (ABs) in patients with the novel coronavirus infection (NCI) reaches over 70% cases. Suspected concomitant bacterial infection, lack of effective means of treating NCI, terminological problems associated with the definition of «pneumonia» may have been the motivating factor for such widespread use. The data of the conducted studies indicate that there is currently insufficient evidence for the widespread empirical use of antibiotics in the majority of hospitalized patients, as the total proportion of bacterial infections in COVID-19 is quite low. Thus, according to most researchers, combined bacterial infection is rare and is less than 10%. Unjustified prescription of ABs to patients with COVID-19 can lead to complications that could otherwise have been avoided, including increased bacterial resistance, Clostridioides difficile infection, kidney failure, and much more. The article provides information on the frequency of AB therapy at various stages of medical care. The analysis of data on the nature of antibiotics prescribed to inpatients and outpatients with COVID-19 in different countries was carried out. Recommendations from different countries on AB therapy in patients with COVID-19 are presented. Conclusion. The data reviewed confirm the discrepancy between the unjustified and excessive prescribing of antibiotics to patients with COVID-19 and the small number of evidence of associated bacterial infections.

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The authors declare that there are no conflicts of interest present.