Antibiotics may not reduce risk of death in hospitalised flu patients
London, Mar 25, 2023, IANS
Prescribing antibiotic therapy to people hospitalised with common viral respiratory infections such as influenza is unlikely to save lives, finds a study.
Respiratory infections account for around 10 per cent of the global disease burden and are the most common reason for prescribing antibiotics.
Many infections are viral and do not require or respond to antibiotics, but concerns about bacterial co-infection often lead to precautionary antibiotic prescribing.
Even as India is grappling with influenza cases, driven by the H3N2 virus, the Indian Medical Association has also urged doctors to avoid use of antibiotics. It advised medical practitioners to give only symptomatic treatment as there is no need for antibiotics.
Concerns around bacterial co-infection in Covid-19 led to widespread use of antibiotics in hospitals and the community. Studies report that in some countries, antibiotics were prescribed for around 70 per cent of Covid-19 patients, even though their use was only justified in about 1 in 10 of them.
"Our new study adds to this evidence, suggesting that giving antibiotics to people hospitalised with common respiratory infections is unlikely to lower the risk of death within 30 days,"said lead author Dr Magrit Jarlsdatter Hovind from Akershus University Hospital and the University of Oslo, Norway.
"Such a high degree of potentially unnecessary prescribing has important implications given the growing threat of antimicrobial resistance," Hovind added.
The study showed that patients prescribed antibiotics at any time during their hospital stay (including at admission) were twice as likely to die within 30 days than those not given antibiotics.
The risk of mortality increased by 3 per cent for each day of antibiotic therapy compared with those not given antibiotics. Whereas, initiating antibiotics at hospital admission was not associated with an increased risk of death within 30 days.
In this analysis, Norwegian researchers retrospectively assessed the impact of antibiotic therapy on mortality in 2,111 adults admitted to Akershus University Hospital after testing positive for influenza virus (H3N2, H1N1, influenza B; 44 per cent), respiratory syncytial virus (RSV; 20 per cent) or Covid-19 (35 per cent) between 2017 and 2021.
Overall, 168 (8 per cent) patients died within 30 days -- 119 patients prescribed antibiotics at admission, 27 patients given antibiotics later during their hospital stay, and 22 patients not prescribed antibiotics.
The researchers also acknowledged some limitations to their study, including that it is an observational study so can't prove causation.
The findings will be presented at European Congress of Clinical Microbiology & Infectious Diseases (ECCMID) in Copenhagen, Denmark in April.