{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T15:09:46Z","timestamp":1780672186801,"version":"3.54.1"},"reference-count":26,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T00:00:00Z","timestamp":1780617600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Victor Babes University of Medicine and Pharmacy, Timisoara"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>(1) Background: Antibiotic co-administration during COVID-19 hospitalization is common, but evidence supporting routine use without confirmed bacterial co-infection is limited, and the impact on post-COVID recovery remains largely uninvestigated; (2) Methods: Single-center prospective observational cohort of 127 hospitalized COVID-19 adults (March 2020\u2013December 2024) across four pandemic waves. Antibiotic exposure was the primary variable. Endpoints were 30-day mortality, ICU admission, and persistent dyspnea at three months. Multivariable logistic regression with Firth\u2019s penalized profile likelihood 95% CI was performed; ROC analysis assessed procalcitonin (PCT) discrimination; (3) Results: Of 127 patients (median age 70.3 years; 63.8% male; 61.4% unvaccinated), 68 (53.5%) received antibiotics. Notably, 61.5% of patients with PCT \u2264 0.25 ng\/mL (viral etiology likely) received antibiotics. After adjustment, antibiotic use was not independently associated with 30-day mortality (OR 0.98, 95% CI 0.27\u20134.05), ICU admission (OR 1.12, 95% CI 0.31\u20134.05), or persistent dyspnea at three months (OR 1.51, 95% CI 0.62\u20134.16). COVID-19 severity was the sole independent mortality predictor (OR 3.563, p = 0.018). At three months, 35.6% reported persistent dyspnea and 14.4% had CT pulmonary fibrosis; (4) Conclusions: Antibiotic exposure did not independently predict short- or long-term outcomes after adjustment for severity, while prescribing was misaligned with PCT-based bacterial probability\u2014supporting biomarker-guided stewardship in epidemic respiratory disease.<\/jats:p>","DOI":"10.3390\/microorganisms14061274","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T14:10:42Z","timestamp":1780668642000},"page":"1274","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Antibiotic Use Patterns and Clinical Outcomes in Hospitalized COVID-19 Patients: A Single-Center Observational Cohort Study with Three-Month Follow-Up"],"prefix":"10.3390","volume":"14","author":[{"given":"Ioana-Georgiana","family":"Cotet","sequence":"first","affiliation":[{"name":"Doctoral School, Department of General Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania"},{"name":"Centre of Molecular Research in Nephrology and Vascular Disease, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4951-1702","authenticated-orcid":false,"given":"Diana-Maria","family":"Mateescu","sequence":"additional","affiliation":[{"name":"Doctoral School, Department of General Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dragos-Mihai","family":"Gavrilescu","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, Dental District, Strada Z\u0103gazului Nr. 3, ONE Floreasca Vista, Sector 1, 014261 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florin Eugen","family":"Constantinescu","sequence":"additional","affiliation":[{"name":"Department of Prosthodontics, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd, 050474 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrei","family":"Marginean","sequence":"additional","affiliation":[{"name":"Department of Surgery, Dr. Victor Popescu Emergency Military Hospital, 9 Gheorghe Laz\u0103r Street, 300080 Timi\u0219oara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2375-2793","authenticated-orcid":false,"given":"Madalin","family":"Margan","sequence":"additional","affiliation":[{"name":"Department of Public Health and Sanitary Management, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan Alexandru","family":"Surducan","sequence":"additional","affiliation":[{"name":"Department of Public Health and Sanitary Management, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roxana","family":"Folescu","sequence":"additional","affiliation":[{"name":"Department of Balneology, Medical Recovery and Rheumatology, Family Discipline, Center for Preventive Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7487-4639","authenticated-orcid":false,"given":"Mihaela-Diana","family":"Popa","sequence":"additional","affiliation":[{"name":"Department of Microbiology, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cris Virgiliu","family":"Precup","sequence":"additional","affiliation":[{"name":"Department of Biology and Life Sciences, Faculty of Medicine, \u201cVasile Goldi\u0219\u201d Western University of Arad, 310025 Arad, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7351-741X","authenticated-orcid":false,"given":"Cristina","family":"Tudoran","sequence":"additional","affiliation":[{"name":"Centre of Molecular Research in Nephrology and Vascular Disease, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania"},{"name":"Department VII, Internal Medicine II, Discipline of Cardiology,  \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania"},{"name":"County Emergency Hospital \u201cPius Brinzeu\u201d, L. Rebreanu, Nr. 156, 300723 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1056\/NEJMoa2001017","article-title":"A Novel Coronavirus from Patients with Pneumonia in China, 2019","volume":"382","author":"Zhu","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_2","unstructured":"World Health Organization (2021). COVID-19 Clinical Management: Living Guidance, WHO. Available online: https:\/\/apps.who.int\/iris\/handle\/10665\/338882."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"962","DOI":"10.1086\/591708","article-title":"Predominant role of bacterial pneumonia as a cause of death in pandemic influenza","volume":"198","author":"Morens","year":"2008","journal-title":"J. Infect. 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