Evidence-based case report: Coinfection of COVID-19 in children and administration of antibiotics

Abstract

A B S T R A C T
Background. COVID-19 in childrenalthoughmostly mild,but can also cause serious
illness and even death. Coinfection, especially bacterialcan increase the severity of the
disease. There is yet sufficient evidence about the role of antibiotics in childhood
COVID-19 with coinfection.Objective. To review the available evidence on the
coinfection in childhood COVID-19 and the role of antibiotic administration.
Method.Online literature search using Pubmed database, google scholar dan Cohcrane
library Results.No study was found that directly evaluate the efficacy of antibiotic in
childhood COVID-19 with coinfection. Three meta-analyses found rates of coinfection
of 5.6%-14% and one case series identified a very high rate (94.2%). Most frequent
pathogens included Mycoplasma pneumonia, Streptococcus pneumonia,and
influenza/parainfluenza viruses. Two RCTsandone case series on antibiotic
administration, but all three studies did not address coinfection status.All three
studies evaluated the combination of azithromycin and hydroxychloroquine. No
changes in illness severity or mortality attributed to the medications, one study
indicated more rapid viral load clearance associated with azithromycin. Conclusion
There is a lack of evidence on the role of antibiotics in the management of childhood
COVID-19with coinfection. Azithromycin can be considered in some cases.