Evaluation of early antibiotics use in non-severe COVID-19 patients admitted with low risk of bacterial infection

Abstract The use of antibiotics is common in the treatment of COVID-19, but adequate evaluation is lacking. This study aimed to evaluate the effect of early antibiotic use in non-severe COVID-19 patients admitted with low risk of bacterial infection. The multi-center retrospective cohort study included 1613 non-severe COVID-19 inpatients admitted with low risk of bacterial infection. During the follow-up of 30 days, the proportion of patients progressed into severe type COVID-19 in the early antibiotics use group was almost 1.5 times than that of the comparision group. In the mixed-effect model, the early use of antibiotics was associated with higher probability of developing severe type, staying in the hospital for over 15 days, and secondary infection. However, it was not significant association with mortality rate. Analysis with propensity score-matched cohort displayed similar results. It is suggested that antibiotic use should be avoided unless absolutely necessary in non-severe COVID-19 patients, particularly in the early stages.