Antibiotic overuse in children with viral infections: lessons from the SARS-CoV-2 pandemic
By
Juliane Wurm
Michael Buettcher
Eric Giannoni
Lisa Kottanattu
Guido F Laube
Anita Niederer-Loher
Nina Schöbi
Jessica Wey
Petra Zimmermann
Nicole Ritz
June 10, 2026
Clinical Scorecard: Excessive Antibiotic Prescription for Viral Infections in Pediatric Patients: Insights Gained from the COVID-19 Pandemic
At a Glance
Category Detail
Condition SARS-CoV-2 infection in pediatric patients Key Mechanisms Antibiotics prescribed despite limited evidence of bacterial infection, influenced by clinical uncertainty and high-risk comorbidities. Target Population Children aged 0–18 years hospitalized with confirmed SARS-CoV-2 infection or symptoms compatible with PIMS-TS. Care Setting Pediatric hospitals in Switzerland
Key Highlights
30% of hospitalized children received antibiotics during COVID-19. 12% had clinically suspected bacterial infection without microbiological confirmation. Predictors of antibiotic use included high-risk comorbidities and fever. Symptoms consistent with viral infections were associated with lower antibiotic use. Need for strengthened antimicrobial stewardship in pediatric care. Guideline-Based Recommendations
Diagnosis
Assess for bacterial infection based on clinical presentation and microbiological testing. Management
Implement antimicrobial stewardship to reduce unnecessary antibiotic prescriptions. Monitoring & Follow-up
Monitor antibiotic use patterns and outcomes in hospitalized pediatric patients. Risks
Inappropriate antibiotic use can lead to antimicrobial resistance and adverse effects. Patient & Prescribing Data
Children hospitalized with SARS-CoV-2 infection.
Antibiotics frequently prescribed despite low risk of serious bacterial co-infection.
Clinical Best Practices
Utilize clear guidelines for antibiotic prescribing in pediatric viral infections. Educate healthcare providers on the risks of unnecessary antibiotic use. Related Resources & Content
