{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T08:47:16Z","timestamp":1792572436058,"version":"4.5.0"},"reference-count":68,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,3,24]],"date-time":"2023-03-24T00:00:00Z","timestamp":1679616000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives. The intensive care unit (ICU), especially in an infectious disease hospital, is both an area with a high consumption of antibiotics (atb) and a \u201creservoir\u201d of multidrug-resistant bacteria. We proposed the analysis of antibiotic therapy practices in such a department that treated, in conditions of a pandemic wave, patients with COVID-19 and its complications. Materials and Methods. This was a retrospective transversal study of 184 COVID-19 patients treated in the ICU of a regional infectious disease hospital of Ia\u015fi, Romania, in a 3-month interval of 2020 and 2021. Results. All the included patients (Caucasians, 53% males, with a median age of 68 years, and a Charlton comorbidity index of 3) received at least one antibiotic during their stay in the ICU (43% also had antibiotics prior to hospital admission and 68% in the Infectious Diseases ward). Only 22.3% of the ICU patients had only one antibiotic. A total of 77.7% of them started with an association of two antibiotics, and 19.6% of them received more than three antibiotics. The most-used ones were linezolid (77.2%), imipenem (75.5%), and ceftriaxone (33.7%). The median atb duration was 9 days. No change in the number or type of atb prescription was seen in 2021 (compared to 2020). Only 9.8% of the patients had a microbiological confirmation of bacterial infection. A total of 38.3% of the tested patients had elevated procalcitonin levels at ICU admission. The overall fatality rate was 68.5%, with no significant differences between the two analyzed periods or the number of administered antibiotics. More than half (51.1%) of the patients developed oral candidiasis during their stay in the ICU, but only 5.4% had C. difficile colitis. Conclusion. Antibiotics were widely used in our ICU patients in the presence of a reduced microbiological confirmation of a bacterial co-infection, and were justified by other clinical or biological criteria.<\/jats:p>","DOI":"10.3390\/medicina59040645","type":"journal-article","created":{"date-parts":[[2023,3,24]],"date-time":"2023-03-24T03:50:21Z","timestamp":1679629821000},"page":"645","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Antibiotic Usage in the COVID-19 Intensive Care Unit of an Infectious Diseases Hospital from Nord-Eastern Romania"],"prefix":"10.3390","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8357-7048","authenticated-orcid":false,"given":"Andrei","family":"V\u00e2\u0163\u0103","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florin Manuel","family":"Ro\u015fu","sequence":"additional","affiliation":[{"name":"Department of Dento-Alveolar Surgery, Anesthesia, Sedation and Medical-Surgical Emergencies, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7720-4499","authenticated-orcid":false,"given":"Olivia Simona","family":"Dorneanu","sequence":"additional","affiliation":[{"name":"Microbiology Department, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 16 Universit\u0103\u021bii Street, 700115 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alina Elisabeta","family":"Lehaci","sequence":"additional","affiliation":[{"name":"\u201cSf\u00e2nta Parascheva\u201d Infectious Disease Hospital of Ia\u015fi, 700116 Ia\u015fi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u015etefana","family":"Luca","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery and Reconstructive Microsurgery, \u201cSt Spiridon\u201d County Emergency Hospital, 700111 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabela Ioana","family":"Loghin","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioana Diandra","family":"Miftode","sequence":"additional","affiliation":[{"name":"Department of Radiology, \u201cSt. Spiridon\u201d County Emergency Clinical Hospital, 700111 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u0103t\u0103lina Mihaela","family":"Luca","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Egidia Gabriela","family":"Miftode","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, \u201cGrigore T. Popa\u201d University of Medicine and Pharmacy, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1186\/gb-2003-4-5-213","article-title":"Discovering human history from stomach bacteria","volume":"4","author":"Disotell","year":"2003","journal-title":"Genome Biol."},{"key":"ref_2","unstructured":"World Health Organisation (2022, November 10). Antibiotic Resistance Fact Sheet. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/antimicrobial-resistance."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1016\/j.idc.2022.08.004","article-title":"Management of Highly Resistant Gram-Negative Infections in the Intensive Care Unit in the Era of Novel Antibiotics","volume":"36","author":"Clancy","year":"2022","journal-title":"Infect. Dis. Clin. N. 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