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Colegio de Medicina Interna de México.

2021, Número 6

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Med Int Mex 2021; 37 (6)


Uso y abuso de antimicrobianos en COVID-19: ¿cuándo está justificado prescribir antibióticos?

Pérez-Martínez CA, Padilla-Santamaría F, Helguera-León SA, Mejía-Cornejo JJ, Casados-Rodríguez BE, Martínez-Abarca CI, Zamarrón-López ÉI, Pérez-Nieto OR

Idioma: Español
Referencias bibliográficas: 79
Paginas: 1015-1029
Archivo PDF: 339.35 Kb.


RESUMEN

La pandemia debida a la enfermedad por coronavirus 2019 (COVID-19) causada por el virus SARS-CoV-2 ha creado retos para su diagnóstico y tratamiento. Al día de hoy no se cuenta con una terapia antiviral específica, esta situación ha presionado al clínico a ofrecer terapias farmacológicas alternas cuyo beneficio puede ser opacado por sus riesgos. Desde el inicio de la pandemia se popularizó la administración de antibióticos empíricos en diversos protocolos de tratamiento en todo el mundo, tratamiento que no está recomendado en las guías nacionales ni internacionales para el manejo del COVID-19. La evidencia actual muestra una incidencia escasa de coinfecciones bacterianas, incluso en cuadros severos. Administrar un antibiótico de forma incorrecta cuando no se tiene indicación sustentada en estudios clínicos se asocia con efectos nocivos importantes, como incremento en la mortalidad. Ante la similitud del cuadro clínico infeccioso del COVID-19 con el de una neumonía bacteriana atípica, descartar un proceso infeccioso de forma concisa y oportuna cobra gran importancia; para esto pueden realizarse estudios bioquímicos y de imagen, además de una buena integración clínica de los signos y síntomas del paciente. En esta revisión se describe la recopilación de la evidencia sobre coinfecciones bacterianas en COVID-19, la administración de antibióticos en esta enfermedad y las posibles consecuencias.


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