Frecuencia de prescripción de antibióticos en adultos hospitalizados por SARS-CoV-2 en una institución de alta complejidad en Santiago de Cali, Colombia
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Objetivo: Determinar la frecuencia del uso de antibióticos y conocer qué variables clínicas y socio-demográficas se relacionaban con la probabilidad de sufrir infecciones asociadas a COVID-19. Métodos: Se evaluaron adultos hospitalizados por COVID-19 quienes recibieron uno o más antibióticos durante su internación. Se realizó un análisis descriptivo de las variables en la población general‚ análisis bivariado en dos grupos (infección documentada vs infección presunta) y regresión logística multivariada de factores asociados a mortalidad. Resultados: Se determinó que el 60,4% de los adultos hospitalizados por COVID-19, recibieron antibióticos. Se documentó coinfección en el 6,2% y sobreinfección en el 23,3%. El 75,8% de los cultivos reportaron gérmenes gramnegativos, 17,8% hongos y 14,2% grampositivos. Variables como edad, comorbilidades, UCI, anemia, esteroides, ventilación mecánica, hemofiltración se relacionaron de forma estadísticamente significativa con infección documentada. La cánula de alto flujo se asoció como factor protector. La mortalidad en general fue del 43.9%, 57.8% en el primer grupo y 38.1% en el segundo (p=0.002). Conclusión: Existe una frecuencia considerable del uso de antibióticos en sujetos hospitalizados por COVID-19, particularmente relacionada con hallazgos relevantes de sobreinfección bacteriana, en aquellos con comorbilidades, como la diabetes mellitus, estados de inmunosupresión, anemia y fragilidad, en quienes el comportamiento de la enfermedad cursa con mayor severidad y letalidad.
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