{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:13:19Z","timestamp":1789603999545,"version":"build-2803163510"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T00:00:00Z","timestamp":1750896000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T00:00:00Z","timestamp":1750896000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Schleswig-Holstein - Campus Kiel"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Infection"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>\n                      The benefit of antibiotic treatment (ABT) for patients with moderate COVID-19 is unclear and overtreatment poses the risk of adverse effects such as\n                      <jats:italic>Clostridioides difficile<\/jats:italic>\n                      infection and antibiotic resistance. This multi-center study compares health status improvement between patients with and without ABT at hospital admission.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Between March 2020 and May 2023, hospitalized adults with confirmed SARS-CoV-2 infection were recruited from the German National Pandemic Cohort Network (NAPKON), which includes patients from various hospitals across Germany. The study population included patients with moderate or severe COVID-19 at baseline. The primary objective was to compare health improvement or decline after two weeks between patients who received ABT at baseline and those who did not in the moderate COVID-19 population. The statistical analysis adjusted for confounders such as gender, age, vaccination status, clinical condition, and comorbidities. The severe COVID-19 population was investigated as a secondary objective.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 1,317 patients (median age 59\u00a0years; 38% women) were eligible for analysis, of whom 1,149 had moderate and 168 severe COVID-19 disease. ABT for pneumonia was administered to 467 patients with moderate and 117 with severe COVID-19. ABT at baseline was significantly associated with a higher deterioration rate after two weeks in patients with moderate COVID-19 (ABT: 292 improvement, 61 deterioration; no ABT: 429 improvement, 14 deterioration). A similar result was obtained in the multiple regression analysis where an odds ratio of 5.00 (95% confidence interval: 2.50 \u2013 10.93) for ABT was observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We found no benefit of antibiotic therapy in patients with moderate COVID-19. Use of ABT was associated with a higher likelihood of clinical deterioration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1007\/s15010-025-02590-0","type":"journal-article","created":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T01:51:11Z","timestamp":1750902671000},"page":"2543-2555","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The effect of antibiotic therapy on clinical outcome in patients hospitalized with moderate COVID-19 disease: a prospective multi-center cohort study"],"prefix":"10.1007","volume":"53","author":[{"given":"Anette","family":"Friedrichs","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roman","family":"Wenz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Pape","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina S.","family":"Appel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Bahmer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karsten","family":"Becker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sven","family":"Bercker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Blaschke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josephine","family":"Braunsteiner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jana","family":"Butzmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Egdar","family":"Dahl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna","family":"Erber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Fricke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramsia","family":"Geisler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siri","family":"G\u00f6pel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"G\u00fcldner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Hagen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axel","family":"Hamprecht","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Hansch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter U.","family":"Heuschmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sina M.","family":"P\u00fctz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bj\u00f6rn-Erik Ole","family":"Jensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadja","family":"K\u00e4ding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Koepsell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolin E. M.","family":"Koll","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcin","family":"Krawczyk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"L\u00fccke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Meybohm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milena","family":"Milovanovic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lazar","family":"Mitrov","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolin","family":"N\u00fcrnberger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"R\u00f6mmele","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margarete","family":"Scherer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lena","family":"Schmidbauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie","family":"Stecher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phil-Robin","family":"Tepasse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Teufel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rg Janne","family":"Vehreschild","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christof","family":"Winter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Witzke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Wyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Hanses","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amke","family":"Caliebe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,6,26]]},"reference":[{"issue":"2","key":"2590_CR1","doi-asserted-by":"publisher","first-page":"423","DOI":"10.1007\/s15010-021-01699-2","volume":"50","author":"MJ Schons","year":"2022","unstructured":"Schons MJ, Caliebe A, Spinner CD, Classen AY, Pilgram L, Ruethrich MM, Rupp J, Nunes de Miranda SM, R\u00f6mmele C, Vehreschild J, Jensen BE, Vehreschild M, Degenhardt C, Borgmann S, Hower M, Hanses F, Haselberger M, Friedrichs AK, LEOSS-study group. All-cause mortality and disease progression in SARS-CoV-2-infected patients with or without antibiotic therapy: an analysis of the LEOSS cohort. Infection. 2022;50(2):423\u201336. https:\/\/doi.org\/10.1007\/s15010-021-01699-2.","journal-title":"Infection"},{"key":"2590_CR2","doi-asserted-by":"publisher","DOI":"10.2147\/IDR.S470957","author":"Y Duan","year":"2024","unstructured":"Duan Y, Ren J, Wang J, Wang S, Zhang R, Zhang H, Hu J, Deng W, Li W, Chen B. The impact of early antibiotic use on clinical outcomes of patients hospitalized with COVID-19: a propensity score-matched analysis. Infect Drug Resist. 2024. https:\/\/doi.org\/10.2147\/IDR.S470957.","journal-title":"Infect Drug Resist"},{"issue":"1","key":"2590_CR3","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics12010045","volume":"12","author":"SS Malik","year":"2022","unstructured":"Malik SS, Mundra S. Increasing consumption of antibiotics during the COVID-19 pandemic: implications for patient health and emerging anti-microbial resistance. Antibiotics. 2022;12(1): 45. https:\/\/doi.org\/10.3390\/antibiotics12010045.","journal-title":"Antibiotics"},{"key":"2590_CR4","unstructured":"https:\/\/register.awmf.org\/assets\/guidelines\/113-001l_S3_Empfehlungen-zur-Therapie-von-Patienten-mit-COVID-19_2024-01_1.pdf"},{"issue":"1","key":"2590_CR5","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1016\/j.cmi.2020.07.041","volume":"27","author":"C Garcia-Vidal","year":"2021","unstructured":"Garcia-Vidal C, Sanjuan G, Moreno-Garc\u00eda E, Puerta-Alcalde P, Garcia-Pouton N, Chumbita M, Fernandez-Pittol M, Pitart C, Inciarte A, Bodro M, Morata L, Ambrosioni J, Grafia I, Meira F, Macaya I, Cardozo C, Casals C, Tellez A, Castro P, Marco F, Garc\u00eda F, Mensa J, Mart\u00ednez JA, Soriano A. Incidence of co-infections and superinfections in hospitalized patients with COVID-19: a retrospective cohort study. Clin Microbiol Infect. 2021;27(1):83\u20138. https:\/\/doi.org\/10.1016\/j.cmi.2020.07.041.","journal-title":"Clin Microbiol Infect"},{"issue":"12","key":"2590_CR6","doi-asserted-by":"publisher","first-page":"1622","DOI":"10.1016\/j.cmi.2020.12.018","volume":"26","author":"BJ Langford","year":"2020","unstructured":"Langford BJ, So M, Raybardhan S, Leung V, Westwood D, MacFadden DR, Soucy J-PR, Daneman N. Bacterial co-infection and secondary infection in patients with COVID-19: a living rapid review and meta-analysis. Clin Microbiol Infect. 2020;26(12):1622\u20139. https:\/\/doi.org\/10.1016\/j.cmi.2020.12.018.","journal-title":"Clin Microbiol Infect"},{"issue":"8","key":"2590_CR7","doi-asserted-by":"publisher","first-page":"e192","DOI":"10.1186\/s13063-020-04641-3","volume":"20","author":"JC Marshall","year":"2020","unstructured":"Marshall JC, Murthy S, Diaz J, et al. A minimal common outcome measure set for COVID-19 clinical research. Lancet Infect Dis. 2020;20(8):e192\u20137. https:\/\/doi.org\/10.1186\/s13063-020-04641-3.","journal-title":"Lancet Infect Dis"},{"key":"2590_CR8","doi-asserted-by":"publisher","first-page":"849","DOI":"10.1007\/s10654-022-00896-z","volume":"37","author":"M Schons","year":"2022","unstructured":"Schons M, Pilgram L, Reese J-P, Stecher M, Anton G, Appel KS, Bahmer T, et al. The German national pandemic cohort network (NAPKON): rationale, study design and baseline characteristics. Eur J Epidemiol. 2022;37:849\u201370. https:\/\/doi.org\/10.1007\/s10654-022-00896-z.","journal-title":"Eur J Epidemiol"},{"issue":"8","key":"2590_CR9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.18637\/jss.v042.i08","volume":"42","author":"D Ho","year":"2011","unstructured":"Ho D, Imai K, King G, Stuart E. MatchIt: nonparametric preprocessing for parametric causal inference. J Stat Softw. 2011;42(8):1\u201328. https:\/\/doi.org\/10.18637\/jss.v042.i08.","journal-title":"J Stat Softw"},{"issue":"9","key":"2590_CR10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.18637\/jss.v111.i09","volume":"111","author":"V Arel-Bundock","year":"2024","unstructured":"Arel-Bundock V, Greifer N, Heiss A. How to interpret statistical models using marginaleffects for R and python. J Stat Softw. 2024;111(9):1\u201332. https:\/\/doi.org\/10.18637\/jss.v111.i09.","journal-title":"J Stat Softw"},{"key":"2590_CR11","unstructured":"R Core Team (2024) R: A language and environment for statistical computing. Vienna: R Foundation for Statistical Computing. Available at: https:\/\/www.R-project.org\/ (Accessed: [09\/03\/2024])."},{"issue":"5","key":"2590_CR12","doi-asserted-by":"publisher","first-page":"463","DOI":"10.1097\/MCC.0000000000000975","volume":"28","author":"W Nedel","year":"2022","unstructured":"Nedel W, da Silveira F, Farias da Silva C, Lisboa T. Bacterial infection in coronavirus disease 2019 patients: co-infection, super-infection and how it impacts on antimicrobial use. Curr Opin Crit Care. 2022;28(5):463\u20139. https:\/\/doi.org\/10.1097\/MCC.0000000000000975.","journal-title":"Curr Opin Crit Care"},{"issue":"6","key":"2590_CR13","doi-asserted-by":"publisher","first-page":"1441","DOI":"10.1007\/s15010-022-01796-w","volume":"50","author":"T Lingscheid","year":"2022","unstructured":"Lingscheid T, Lippert LJ, Hillus D, Kruis T, Thibeault C, Helbig ET, Tober-Lau P, Pf\u00e4fflin F, M\u00fcller-Redetzky H, Witzenrath M, Zoller T, Uhrig A, Opitz B, Suttorp N, Kramer TS, Sander LE, Stegemann MS, Kurth F. Characterization of antimicrobial use and co-infections among hospitalized patients with COVID-19: a prospective observational cohort study. Infection. 2022;50(6):1441\u201352. https:\/\/doi.org\/10.1007\/s15010-022-01796-w.","journal-title":"Infection"},{"key":"2590_CR14","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopha.2021.112481","volume":"146","author":"A Rosca","year":"2022","unstructured":"Rosca A, Balcaen T, Lanoix J-P, Michaud A, Moyet J, Marcq I, Schmit J-L, Bloch F, Deschasse G. Mortality risk and antibiotic use for COVID-19 in hospitalized patients over 80. Biomed Pharmacother. 2022;146: 112481. https:\/\/doi.org\/10.1016\/j.biopha.2021.112481.","journal-title":"Biomed Pharmacother"},{"issue":"3","key":"2590_CR15","doi-asserted-by":"publisher","first-page":"579","DOI":"10.1080\/17843286.2021.1916300","volume":"77","author":"S Milas","year":"2022","unstructured":"Milas S, Poncelet A, Buttafuoco F, Pardo A, Lali SE, Cherifi S. Antibiotic use in patients with Coronavirus disease 2019 (COVID-19): outcomes and associated factors. Acta Clin Belg. 2022;77(3):579\u201387. https:\/\/doi.org\/10.1080\/17843286.2021.1916300.","journal-title":"Acta Clin Belg"},{"issue":"9","key":"2590_CR16","doi-asserted-by":"publisher","first-page":"1168","DOI":"10.1097\/CCM.0000000000005901","volume":"51","author":"JC Widere","year":"2023","unstructured":"Widere JC, Davis CL, Loomba JJ, Bell TD, Enfield KB, Barros AJ. Early empiric antibiotic use in patients hospitalized with COVID-19: a retrospective cohort study. Crit Care Med. 2023;51(9):1168\u201376. https:\/\/doi.org\/10.1097\/CCM.0000000000005901.","journal-title":"Crit Care Med"},{"key":"2590_CR17","doi-asserted-by":"publisher","first-page":"256","DOI":"10.1016\/j.ijid.2021.01.051","volume":"105","author":"F Moretto","year":"2021","unstructured":"Moretto F, Sixt T, Devilliers H, et al. Is there a need to widely prescribe antibiotics in patients hospitalized with COVID-19? Int J Infect Dis. 2021;105:256\u201360. https:\/\/doi.org\/10.1016\/j.ijid.2021.01.051.","journal-title":"Int J Infect Dis"},{"key":"2590_CR18","doi-asserted-by":"publisher","first-page":"1280434","DOI":"10.3389\/fpubh.2023.1280434","volume":"11","author":"R Mehrizi","year":"2023","unstructured":"Mehrizi R, Golestani A, Malekpour MR, et al. Drug prescription patterns and their association with mortality and hospitalization duration in COVID-19 patients: insights from big data. Front Public Health. 2023;11:1280434.","journal-title":"Front Public Health"},{"issue":"6","key":"2590_CR19","doi-asserted-by":"publisher","DOI":"10.3390\/jpm12060877","volume":"12","author":"L Pinte","year":"2022","unstructured":"Pinte L, Ceasovschih A, Niculae CM, et al. Antibiotic prescription and in-hospital mortality in COVID-19: a prospective multicentre cohort study. J Pers Med. 2022;12(6): 877. https:\/\/doi.org\/10.3390\/jpm12060877.","journal-title":"J Pers Med"},{"key":"2590_CR20","unstructured":"AWMF_ 113\u2013001_S3-Leitlinie - Empfehlungen zur Therapie von Patienten mit COVID-19, Version 10.0 (2024)"}],"container-title":["Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s15010-025-02590-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s15010-025-02590-0","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s15010-025-02590-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T11:02:31Z","timestamp":1770634951000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s15010-025-02590-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,26]]},"references-count":20,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["2590"],"URL":"https:\/\/doi.org\/10.1007\/s15010-025-02590-0","relation":{},"ISSN":["0300-8126","1439-0973"],"issn-type":[{"value":"0300-8126","type":"print"},{"value":"1439-0973","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,26]]},"assertion":[{"value":"4 March 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 June 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 June 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}