Antibiotic-associated syndrome in SARS-CoV-2 coronavirus infection

Abstract

The negative consequences of antibiotic therapy include, in particular, antibiotic-associated diarrhea, which has been well studied and described to date. However, studies have shown that the clinical symptoms associated with antibiotic therapy are wider than the development of antibiotic-associated diarrhea alone, and are characterized by the development of a symptom complex defined as an antibiotic-associated syndrome. The aim of this study was to establish the clinical features of the antibiotic-associated syndrome in coronavirus infection caused by the SARS-CoV-2 virus. A prospective clinical observation was carried out using the questionnaire method from 2017 to 2022. In total, 147 parents of patients aged 3 months to 18 years who had acute respiratory viral infections (90 people) and COVID-19 (57 people) were interviewed, of which 120 children received antibiotic therapy. Parents of patients filled out a questionnaire to identify the main clinical manifestations of the antibiotic-associated syndrome. A comparative analysis of the clinical manifestations of the antibiotic-associated syndrome in patients with acute respiratory viral infections showed that diarrhea, gastrointestinal and extraintestinal manifestations within a month after recovery were observed in a larger number of patients in the case of prescribing probiotics after completing a course of antibiotic therapy. Significant differences in the effectiveness of bifidobacteria and lactoprobiotics in the prevention of antibiotic-associated syndrome have not been established, with the exception of a lower incidence of constipation in patients who received probiotics containing Bifidobacterium spp. Clinical manifestations of antibiotic-associated syndrome in patients with COVID-19 were observed in more children than in SARS. In acute respiratory viral infections, including coronavirus infection caused by the SARS-CoV-2 virus, the prescription of antibacterial drugs is pathogenetically unjustified and increases the risk of developing an antibiotic-associated syndrome. If it is necessary to use antibacterial drugs in this category of patients, it is most advisable to prescribe probiotic therapy simultaneously with an antibiotic.