key: cord-0820601-2x598y2v
authors: nan
title: Comment on ‘High rates of antibiotic prescriptions in children with COVID‐19 or multisystem inflammatory syndrome: A multinational experience in 990 cases from Latin America
date: 2021-06-21
journal: Acta Paediatr
DOI: 10.1111/apa.15980
sha: 8a22738032d6c4f1474acb1b33ff69d16c825b74
doc_id: 820601
cord_uid: 2x598y2v

We read the article "High rates of antibiotic prescriptions in children with COVID-19 or multisystem inflammatory syndrome: A multinational experience in 990 cases from Latin America" by Yock-Corrales.A et.al. published in Acta Paediatrica in March 2021 with interest. We would like to congratulate the authors and make some contributions based on our regional observational study from the United Kingdom on this highlighted concern.

We read the article 'High rates of antibiotic prescriptions in children with We would like to congratulate the authors and make some contributions based on our regional observational study from the UK on this highlighted concern.

Yock-Corrales A. et al. report on the antibiotic prescriptions and its determinants in children with COVID-19 or MIS-C in five Latin American countries. Antibiotic prescription prevalence was reported to be 24.5%. 1 A high rate of antibiotic prescriptions was observed in children with MIS-C, on respiratory support, radiological evidence of pneumonia and fever. It raises a real emerging concern of antibiotic resistance as an effect of this pandemic.

We report a similar observation made in the West Midlands, UK, in hospitalised children, reviewing the regional practice of management of children with suspected/confirmed COVID-19 and PIMS-TS (MIS-C). 2 Children (≤16 years old) admitted to paediatric wards with suspected COVID-19 infection between 1 March and 31 July 2020 from nine district general hospitals were included.

During this first wave, the suspicion levels for COVID-19 were high; however, timely screening and turnover time of RT-PCR swab were evolving. Hence, diagnoses were predominantly based on clinical suspicion and contact history. 'Suspected COVID-19' was defined as those admitted with fever and symptoms asso- This observed high antibiotic use in a UK cohort, in particular broad-spectrum antibiotics, in the presence of low culture positivity and PIMS-TS is alarming. However, this study was conducted in the first wave, when there was an uncertainty on the impact of novel coronavirus on children and the challenges in distinguishing PIMS-TS and sepsis persisted. Our knowledge has since exponentially heightened, and it is evident that the majority of children infected with COVID-19 have mild or few symptoms. From the reported evidence, the rates of bacterial and fungal co-infections are low in the early phase of COVID-19. 3 With the ongoing pandemic worldwide and the concern of a third wave, it is important that this awareness is disseminated and antibiotic stewardship strategies are incorporated in the management of children with COVID-19.

The authors declare that there is no conflict of interest. 

Co-infections in people with COVID-19: a systematic review and meta-analysis

Additional supporting information may be found online in the Supporting Information section. How to cite this article: ; Paediatric Research Across the Midlands (PRAM) Network. Comment on 'High rates of antibiotic prescriptions in children with COVID-19 or multisystem inflammatory syndrome: A multinational experience in 990 cases from Latin America