Recommendations for antibacterial therapy in adults with COVID-19 – An evidence based guideline

The Dutch Working Party on Antibiotic Policy constituted a multidisciplinary expert committee to provide evidence-based recommendation for the use of antibacterial therapy in hospitalized adults with a respiratory infection and suspected or proven 2019 Coronavirus disease (COVID-19).

The 2019 Coronavirus (COVID-19) pandemic due to the novel SARS Coronavirus (SARS-CoV-2) has resulted in a sudden, large and prolonged increase in hospitalizations of patients fulfilling the criteria for community-acquired pneumonia (CAP). SARS-CoV-2 can lead to a wide spectrum of disease, ranging from very mild symptoms of upper respiratory tract infection to life-threatening pneumonia. Severe disease is frequently associated with high inflammation marker levels. It is therefore challenging to define if a patient fulfilling criteria for CAP who is positive for SARS-CoV-2 has a bacterial co-infection upon admission. During hospitalization it may be difficult to distinguish between severe COVID-19 and bacterial secondary infections.