Objective:

To evaluate the impact of empiric antibiotics targeting community-acquired pneumonia (CAP) on outcomes in hospitalized patients with nonsevere COVID-19 infections.

Key Findings:

• 21% of patients treated with antibiotics experienced clinical deterioration or in-hospital mortality compared to 18% who did not (p-value needed).
• In-hospital mortality was 5% in the antibiotic group versus 4% in the non-antibiotic group (p-value needed).
• Median hospital length of stay was longer for patients treated with antibiotics.
• No significant differences in adverse outcomes like kidney failure or C. difficile infection were observed.

Interpretation:

Empiric antibiotic treatment for nonsevere COVID-19 infections may not provide meaningful benefits and could be associated with increased risks of clinical deterioration and mortality.

Limitations:

• Observational design may lead to residual confounding.
• Lack of physiologic measures limited adjustment for disease severity.
• Reliance on administrative coding for diagnoses and outcomes may impact findings.

Conclusion:

Antibiotic stewardship strategies are needed to promote appropriate antibiotic use in nonsevere COVID-19 patients, given the low rates of confirmed bacterial coinfection and the associated risks.