FAQ: Should Antibiotic Therapy be Continued in Patients Diagnosed with COVID-19?

The ability to streamline and de-escalate empiric antibiotic therapy remains a challenge for antimicrobial stewardship programs. This challenge is further complicated by the ongoing pandemic and increased concern for COVID-19 infection, especially in light of reported mortality rates associated with severe disease presentation. Providers may decide to continue antibiotic therapy in the setting of viral illness due to a concern for bacterial co-infection.

Viral and bacterial co-infections have been largely described in clinical literature for influenza although data can be found for other respiratory illnesses (i.e. RSV, rhinovirus, adenovirus).1 Prompt identification of bacterial infection in viral illness is critical as coinfection has been associated with increased rates of shock, required mechanical ventilation,
prolonged ICU stay, and increased mortality.