Antibiotic Use Among Hospitalized Patients with COVID-19 Infection (SARS-CoV-2 Omicron Variant) in Oman: A Single-center Retrospective Study

Objectives: To identify and evaluate the prescribing pattern of antibiotics among hospitalized patients with SARS-CoV-2, Omicron variant in Oman, focusing on the prevalence of antibiotic use, rates of simultaneous infection, and potential overuse. Methods: This retrospective study analyzed data from the electronic medical records of patients with COVID-19 caused by SARS-CoV-2 Omicron variant who were hospitalized at the Royal Hospital, Muscat, during December 2021–February 2022. Information on demographic and clinical details (including existing infections and comorbidities), hospital stays, and outcomes were collected. The prevalence and pattern of antibiotic use were examined, an association with their disease characteristics and simultaneous infection status were assessed. Statistical analysis was performed using R software. Associations between categorical variables were evaluated using chi-square test. Results: The participants were 176 hospitalized COVID-19 patients (mean age 59.3 ± 18.6 years), of whom 69.9% had mild disease and 22.7% had severe disease. Simultaneous infection (coinfection or superinfection) was present in 11 (6.3%) patients, including 7 (4.0%) bacterial infections as revealed by culture tests. Despite the low rate of simultaneous infections, 104 (59.1%) patients received antibiotics, as follows: ceftriaxone (45.2%), piperacillin and tazobactam (45.2%), and vancomycin (21.2%). Half of the patients who received antibiotics used them for only one to three days with a median duration of four days (range = 1–16). Antibiotic use was significantly associated with patient sex (p =0.030), and the presence of simultaneous infection (p =0.029). The number and duration of antibiotic treatment also showed significant associations with various patient and disease characteristics. Conclusions: Despite low rates of confirmed bacterial infections, antibiotics were administered to majority of hospitalized patients with COVID-19 (Omicron variant). This finding emphasizes the need for strengthening antimicrobial stewardship to curb unnecessary antibiotic use and reduce the risk of antibiotic resistance during pandemics in Oman.