Antimicrobial Therapy and COVID-19 — the 'Great Confrontation'
https://doi.org/10.37489/0235-2990-2022-67-9-10-63-68
Abstract
The problem of antimicrobial therapy (AMT) for the new coronavirus infection has been the cornerstone of practical healthcare since its emergence to the present day. The article summarizes a number of problems concerning the unjustified prescription of AMT based on the data of foreign and domestic studies, as well as actual clinical practice. On the one hand, viral damage to the lung tissue during COVID-19 is difficult to distinguish from community-acquired or secondary bacterial pneumonia; it prompts clinicians to prevent possible bacterial complications in the lungs by prescribing broad-spectrum antibiotics starting from the first day. On the other hand, the presence of clear clinical and biological markers of bacterial pneumonia; and COVID-19 makes it possible not to use antibiotics in routine practice, at least in the early stages of treatment. The introduction of procalcitonin as a biomarker of bacterial infection in COVID-19 into everyday clinical practice has a reasonable, methodical, and scientific approach to prescribing antibiotics.
About the Authors
A. A. Zaytsev
Main Military Clinical Hospital named after academician N. N. Burdenko of the Ministry of Defense of the Russian Federation; Moscow State University of Food Production — Medical Institute of Continuous Education
Russian Federation
Russian Federation
Andrey A. Zaytsev — D. Sc. in Medicine, Professor, Distinguished physician of the Russian Federation, Chief Pulmonologist; Head of the Department of Pulmonology (with a course in Allergology)
SPIN: 6549-5154
11 Volokolamskoe highway, Moscow, 125080
A. М. Makarevich
301st Military Clinical Hospital of the Ministry of Defense of the Russian Federation
Russian Federation
Russian Federation
Andrey М. Makarevich — Ph. D. in Medicine, Distinguished physician of the Russian Federation, Pulmonologist, Deputy Head (for clinical and expert work)
Khabarovsk
References
1. Министерство здравоохранения Российской Федерации. Временные методические рекомендации. Профилактика, диагностика и лечение новой коронавирусной инфекции (COVID-19). Версия 15 (22.02.2022). Доступно по: https://static-0.minzdrav.gov.ru/system/attachments/attaches/000/059/392/original/ВМР_COVID-19_V15.pdf. Ссылка активна на 10.07.2022. [Ministerstvo zdravookhraneniya Rossiiskoi Federatsii. Vremennye metodicheskie rekomendatsii. Profilaktika, diagnostika i lechenie novoi koronavirusnoi infektsii (COVID-19). Versiya 15 (22.02.2022). Available from: https://static-0.minzdrav.gov.ru/system/attachments/attaches/000/059/392/original/ВМР_COVID-19_V15.pdf. Accessed: July 10, 2022. (in Russian)]
2. Зайцев А.А., Чернов С.А., Крюков Е.В., Голухова Е.З., Рыбка М.М. Практический опыт ведения пациентов с новой коронавирусной инфекцией COVID-19 в стационаре (предварительные итоги и рекомендации). Лечащий врач. 2020; 6: 74–79. [Zaytsev A.A., Chernov S.A., Kryukov E.V., Golukhova E.S., Rybka M.M. Practical experience of managing patients with novel coronavirus infection COVID-19 in hospital (preliminary results and guidelines). Lechashchiy Vrach Journal. 2020; 6: 74–79 (in Russian)]
3. Зайцев, А. А. Письмо в редакцию. Клиническая микробиология и антимикробная химиотерапия. 2020; 22 (2): 84–86. https://doi.org/10.36488/cmac.2020.2.84-86. [Zaytsev A.A. Letter to editors. Clinical Microbiology and Antimicrobial Chemotherapy. 2020; 22 (2): 84–86 (in Russian)]
4. Зайцев А.А., Чернов С.А., Стец В.В. и др. Алгоритмы ведения пациентов с новой коронавирусной инфекцией COVID-19 в стационаре. Методические рекомендации. Consilium Medicum. 2020; 22 (11): https://doi.org/10.26442/20751753.2020.11.200520. [Zaitsev A.A., Chernov S.A., Stets V.V. et al. Algorithms for the management of patients with a new coronavirus COVID-19 infection in a hospital. Guidelines. Consilium Medicum. 2020; 22 (11): https://doi.org/10.26442/20751753.2020.11.200520. (in Russian)]
5. Griffin D.O., Brennan-Rieder D., Ngo B. et. al. The Importance of Understanding the Stages of COVID-19 in Treatment and Trials. AIDS Rev. 2021 Feb 8; 23 (1): 40–47. doi: 10.24875/AIDSRev.200001261.
6. Li J., Wang J., Yang Y., Cai P., Cao J., Cai X., Zhang Y. Etiology and antimicrobial resistance of secondary bacterial infections in patients hospitalized with COVID-19 in Wuhan, China: a retrospective analysis. Antimicrob Resist Infect Control. 2020 Sep 22; 9 (1): 153. doi: 10.1186/s13756-020-00819-1.
7. Rawson T.M., Moore L.S.P., Zhu N., Ranganathan N., Skolimowska K., Gilchrist M. et al. Bacterial and fungal coinfection in individuals with coronavirus: a rapid review to support COVID-19 antimicrobial prescribing. Clin Infect Dis. 2020 Dec 3; 71 (9): 2459–2468. doi: 10.1093/cid/ciaa530.
8. De Waele J.J., Derde L., Bassetti M. Antimicrobial stewardship in ICUs during the COVID-19 pandemic: back to the 90s? Intensive Care Med. 2021 Jan; 47 (1): 104–106. doi: 10.1007/s00134-020-06278-x. Epub 2020 Oct 17.
9. Зайцев А.А., Яковлев С.В., Козлов Р.С., Сидоренко С.В., Белевский А.С., Малахов А.Б. и др. О применении антибактериальной терапии у пациентов с новой коронавирусной инфекцией COVID-19. Терапевтический архив. 2020; 92 (11): 4. [Zaitsev A.A., Yakovlev S.V., Kozlov R.S., Sidorenko S.V., Belevskii A.S., Malakhov A.B. et al. About the use of antibacterial therapy in patients with a new coronavirus infection COVID-19. Therapeutic Archive. 2020; 92 (11): 4 (in Russian)]
10. Министерство здравоохранения Российской Федерации. Клинические рекомендации. Внебольничная пневмония у взрослых. 2021. Доступно по: https://cr.minzdrav.gov.ru/schema/654_1. Ссылка активна на 12.07.2022. [Ministerstvo zdravookhraneniya Rossiiskoi Federatsii. Klinicheskiye rekomendatsii. Vnebolnichnaya pnevmoniya u vzroslykh. 2021. Available from: https://cr.minzdrav.gov.ru/schema/654_1. (in Russian)]
11. Зайцев А.А., Овчинников Ю.В., Кондратьева Т.В. Анализ клиникодиагностических возможностей инструментов оценки тяжести и прогноза внебольничной пневмонии у пациентов молодого возраста из организованных коллективов. Пульмонология. 2014; 5: 67–72. https://doi.org/10.18093/0869-0189-2014-0-5-67-72. [Zaytsev A.A., Ovchinnikov Yu.V., Kondrat'eva T.V. An analysis of diagnostic values of prognostic tools for communityacquired pneumonia in young patients in a closed community. Pulmonologiya. 2014; 5: 67–72. https://doi.org/10.18093/0869-0189-2014-0-5-67-72. (in Russian)]
12. Зайцев А.А., Голухова Е.З., Мамалыга М.Л., Чернов С.А., Рыбка М.М., Крюков Е.В. и др. Эффективность пульс-терапии метилпреднизолоном у пациентов с COVID-19. Клиническая микробиология и антимикробная химиотерапия. 2020; 22 (2): 88–91. https://doi.org/10.36488/cmac.2020.2.88-91. [Zaitsev A. A., Golukhova E.Z., Mamalyga M.L., Chernov S.A., Rybka M.M., Kryukov E.V. et al. Efficacy of methylprednisolone pulse therapy in patients with COVID-19. Clinical Microbiology and Antimicrobial Chemotherapy. 2020; 22 (2): 88–91. https://doi.org/10.36488/cmac.2020.2.88-91. (in Russian)]
13. Guan W.J., Ni Z.Y., Hu Y., Liang W.H., Ou C.Q., He J.X. et al. China medical treatment expert group for COVID-19. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020 Apr 30; 382 (18): 1708–1720. doi: 10.1056/NEJMoa2002032. Epub 2020 Feb 28.
14. Chen N., Zhou M., Dong X., Qu J., Gong F., Han Y. et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020 Feb 15; 395 (10223): 507–513. doi: 10.1016/S0140-6736(20)30211-7. Epub 2020 Jan 30.
15. Ingram P.R, Inglis T., Moxon D., Speers D. Procalcitonin and C-reactive protein in severe 2009 H1N1 influenza infection. Intensive Care Med. 2010 Mar; 36 (3): 528–32. doi: 10.1007/s00134-009-1746-3.
16. Cuquemelle E., Soulis F., Villers D., Roche-Campo F., Ara Somohano C., Fartoukh M. et al. A/H1N1 REVA-SRLF Study Group. Can procalcitonin help identify associated bacterial infection in patients with severe influenza pneumonia? A multicentre study. Intensive Care Med. 2011 May; 37 (5): 796–800. doi: 10.1007/s00134-011-2189-1. Epub 2011 Mar3.
17. Zhang G., Hu C., Luo L., Fang F., Chen Y., Li J. et al. Clinical features and short-term outcomes of 221 patients with COVID-19 in Wuhan, China. J Clin Virol. 2020 Jun; 127: 104364. doi: 10.1016/j.jcv.2020.104364. Epub 2020 Apr 9.
18. Huang I., Pranata R., Lim M.A., Oehadian A., Alisjahbana B. C-reactive protein, procalcitonin, D-dimer, and ferritin in severe coronavirus disease-2019: a meta-analysis. Ther Adv Respir Dis. 2020 Jan-Dec; 14: 1753466620937175. doi: 10.1177/1753466620937175.
19. Zheng Z., Peng F., Xu B., Zhao J., Liu H., Peng J. et al. Risk factors of critical & mortal COVID-19 cases: A systematic literature review and meta-analysis. J Infect. 2020 Aug; 81 (2): e16–e25. doi: 10.1016/j.jinf.2020.04.021. Epub 2020 Apr 23.
20. Chedid M., Waked R., Haddad E., Chetata N., Saliba G., Choucair J. Antibiotics in treatment of COVID-19 complications: a review of frequency, indications, and efficacy. J Infect Public Health. 2021 May; 14 (5): 570–576. doi: 10.1016/j.jiph.2021.02.001. Epub 2021 Feb 9.
21. Zhou F., Yu T., Du R., Fan G., Liu Y., Liu Z. et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020 Mar 28; 395 (10229): 1054–1062. doi: 10.1016/S0140-6736(20)30566-3.
22. Langford B.J., So M., Raybardhan S., Leung V., Westwood D., MacFadden D.R., Soucy J.R., Daneman N. Bacterial co-infection and secondary infection in patients with COVID-19: a living rapid review and metaanalysis. Clin Microbiol Infect. 2020 Dec; 26 (12): 1622–1629. doi: 10.1016/j.cmi.2020.07.016. Epub 2020 Jul 22.
23. Langford B.J., So M., Raybardhan S., Leung V., Soucy J.R., Westwood D., Daneman N., MacFadden D.R. Antibiotic prescribing in patients with COVID-19: rapid review and meta-analysis. Clin Microbiol Infect. 2021 Apr; 27 (4): 520–531. doi: 10.1016/j.cmi.2020.12.018. Epub 2021 Jan 5.
24. Визель А. А., Абдулганиева Д. И., Баялиева А. Д., Ванюшин А.А., Салахова И.Н., Вафина А.Р. и др. Анализ ведения больных с новой инфекцией COVID-19: опыт первых 5 мес. Практическая пульмонология. 2020; 3: 61–73. [Vizel А.A., Abdulganieva D.I., Bayalieva A.D., Vanyushin A.A., Salakhova I.N.,Vafina A.R. et al. The analysis of management of patients with COVID-19: experience of the first 5 months. Prakticheskaya Pulmonologiya. 2020; 3: 61–72. (in Russian)]
25. Иванчик Н.В., Чагарян А.Н., Сухорукова М.В., Козлов Р.С., Дехнич А.В., Кречикова О.И. и соавт. Антибиотикорезистентность клинических штаммов Streptococcus pneumoniae в России: результаты многоцентрового эпидемиологического исследования «ПеГАС 2014–2017». Клиническая микробиология и антимикробная химиотерапия. 2019; 21 (3): 230–237. https://doi.org/10.36488/cmac.2019.3.230-237. [Ivanchik N.V., Chagaryan А.N., Sukhorukova М.V., Kozlov R.S., Dekhnich А.V., Krechikova О.I. et al. Antimicrobial resistance of clinical Streptococcus pneumoniae isolates in Russia: the results of multicenter epidemiological study «PEHASus 2014–2017». Clinical Microbiology and Antimicrobial Chemotherapy. 2019; 21 (3): 230–237. https://doi.org/10.36488/cmac.2019.3.230-237. (in Russian)]
26. Эйдельштейн И.А., Эйдельштейн М.В., Романов А.В., Зайцев А.А., Раковская И.В., Бархатова О.И. и др. Четыре случая выявления мутаций устойчивости в гене 23s РРНК Mycoplasma pneumoniae, выделенных от военнослужащих с пневмонией, находящихся на лечении в военном госпитале. Клиническая микробиология и антимикробная химиотерапия. 2017; 19 (3): 248–253. [Edelstein I.A., Edelstein M.V., Romanov A.V., Zaitsev A.A., Rakovskaya I.V. et al. Four cases of resistance mutations in 23S rRNA gene in Mycoplasma pneumoniae isolated from the hospitalized military personnel. Clinical Microbiology and Antimicrobial Chemotherapy. 2017; 19 (3): 248–253. (in Russian)]
27. Орлов Ф.А., Зайцев А.А., Кубенский Г.Е., Пантюхова Т.Н. Оценка длительности интервала QT у пациентов с COVID-19 на фоне лечения гидроксихлорохином и азитромицином. Consilium Medicum. 2020; 22 (12): 15–19. https://doi.org/10.26442/20751753.2020.12.200540. [Orlov F.A., Zaitsev A.A., Kubenskii G.E., Pantiukhova T.N. Assessment of the duration of QT interval in patients with COVID-19 during treatment with hydroxychloroquine and azithromycin. Consilium Medicum. 2020; 22 (12): 15–19. https://doi.org/10.26442/20751753.2020.12.200540. (in Russian)]
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For citations:
Zaytsev A.A., Makarevich A.М. Antimicrobial Therapy and COVID-19 — the 'Great Confrontation'. Antibiot Khimioter = Antibiotics and Chemotherapy. 2022;67(9-10):63-68. (In Russ.) https://doi.org/10.37489/0235-2990-2022-67-9-10-63-68
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