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00925njm 22002777a 4500 dc Calderón-Parra, Jorge author Muiño-Miguez, Antonio author Bendala-Estrada, Alejandro D author Ramos-Martínez, Antonio author Muñez-Rubio, Elena author Fernández Carracedo, Eduardo author Tejada Montes, Javier author Rubio-Rivas, Manuel author Arnalich-Fernandez, Francisco author Beato Pérez, Jose Luis author García Bruñén, Jose Miguel author Del Corral Beamonte, Esther author Pesqueira Fontan, Paula Maria author Carmona, Maria Del Mar author Fernández-Madera Martínez, Rosa author González García, Andrés author Salazar Mosteiro, Cristina author Tuñón de Almeida, Carlota author González Moraleja, Julio author Deodati, Francesco author Martín Escalante, María Dolores author Asensio Tomás, María Luisa author Gómez Huelgas, Ricardo author Casas Rojo, José Manuel author Millán Núñez-Cortés, Jesús author SEMI-COVID-19 Network author 2021-05-11 Most patients with COVID-19 receive antibiotics despite the fact that bacterial co-infections are rare. This can lead to increased complications, including antibacterial resistance. We aim to analyze risk factors for inappropriate antibiotic prescription in these patients and describe possible complications arising from their use. The SEMI-COVID-19 Registry is a multicenter, retrospective patient cohort. Patients with antibiotic were divided into two groups according to appropriate or inappropriate prescription, depending on whether the patient fulfill any criteria for its use. Comparison was made by means of multilevel logistic regression analysis. Possible complications of antibiotic use were also identified. Out of 13,932 patients, 3047 (21.6%) were prescribed no antibiotics, 6116 (43.9%) were appropriately prescribed antibiotics, and 4769 (34.2%) were inappropriately prescribed antibiotics. The following were independent factors of inappropriate prescription: February-March 2020 admission (OR 1.54, 95%CI 1.18-2.00), age (OR 0.98, 95%CI 0.97-0.99), absence of comorbidity (OR 1.43, 95%CI 1.05-1.94), dry cough (OR 2.51, 95%CI 1.94-3.26), fever (OR 1.33, 95%CI 1.13-1.56), dyspnea (OR 1.31, 95%CI 1.04-1.69), flu-like symptoms (OR 2.70, 95%CI 1.75-4.17), and elevated C-reactive protein levels (OR 1.01 for each mg/L increase, 95% CI 1.00-1.01). Adverse drug reactions were more frequent in patients who received ANTIBIOTIC (4.9% vs 2.7%, p The inappropriate use of antibiotics was very frequent in COVID-19 patients and entailed an increased risk of adverse reactions. It is crucial to define criteria for their use in these patients. Knowledge of the factors associated with inappropriate prescribing can be helpful. 10.1371/journal.pone.0251340 1932-6203 PloS one http://hdl.handle.net/10668/17779 33974637 http://hdl.handle.net/20.500.12105/18339 Inappropriate antibiotic use in the COVID-19 era: Factors associated with inappropriate prescribing and secondary complications. Analysis of the registry SEMI-COVID.