Effectiveness of antibiotic therapy in critically ill COVID-19 patients depending on age of patients and doses of hormonal drugs

  • V. I. Trykhlib Ukrainian Military Medical Academy https://orcid.org/0000-0001-9250-4385
  • T. I. Lysenko Ukrainian Military Medical Academy
  • A. O. Yeroshenko Ukrainian Military Medical Academy
  • O. S. Martynchyk Ukrainian Military Medical Academy
  • N. R. Tsiurak Ukrainian Military Medical Academy
  • K. P. Bieliaieva Ukrainian Military Medical Academy
Keywords: COVID-19, seriously ill patients, antibiotic therapy.

Abstract

Introduction. The article presents a review of the literature on co-infections in COVID-19 coronavirus infection and presents data from a personal study on antibiotic therapy in critically ill patients with COVID-19.

Objective. To establish the effectiveness of antibiotic therapy in the treatment of the new coronavirus infection COVID-19 in critically ill patients who were treated in the ICU, against the background of various doses of hormonal therapy and various antibiotic therapy regimens.

Materials and methods. The data of 112 medical records of an inpatient, patients with a severe course of the new coronavirus disease COVID-19, who were treated in the ICU of the NMMCC "MMCH" in the period from January to April 2021 were processed.

All patients were diagnosed with pneumonia by chest x-ray or computed tomography. In all patients the diagnosis was confirmed by real-time PCR with the detection of SARS-COV-2 RNA. Statistical processing of research materials was carried out using a personal computer using the STATISTICA program. A questionnaire was developed for entering data into Excel.

Results.The article presents a review of the literature on co-infection in COVID-19 coronavirus infection and presents data from a personal study on antibiotic therapy in critically ill patients with COVID-19. It was found that there were fewer fatal cases (9.1%) among critically ill patients who took antibiotics before hospitalization than among those who did not take antibiotics (29.3%). In the hospital, antibiotics were prescribed later than 9 days of the disease, lasting about 7 days. Predominantly severely ill patients in the intensive care unit were prescribed either one or two antibiotics. There were no deaths under 60 years of age in our sample. According to our data, there were more patients who recovered when using the following antibiotic regimens: penicillins + fluoroquinolones; fluoroquinolones; carbapenems. In patients who received, in addition to antibiotics, 8 mg of dexamethasone, fewer died on the following regimens: penicillins + fluoroquinolones; cephalosporins + fluoroquinolones; carbapenems. In other patients who received, in addition to antibiotics, 16 mg of dexamethasone, fewer died on the background of the use of: penicillins + fluoroquinolones; fluoroquinolones; carbapenems. It is concluded that further research on the effectiveness of early prescription of antibacterial drugs (penicillins + fluoroquinolones, fluoroquinolones) in critically ill and moderately ill patients, and the development of criteria for prescribing antibiotic therapy.

Conclusions. Fewer deaths were found in seriously ill patients with COVID-19 who took antibiotics before hospitalization, compared with those who did not take antibiotics.

From the generalized data on the consequences of treatment with antibacterial drugs, a greater number of deaths were found in those who received antibacterial drugs during treatment. At the same time, a slightly smaller number of deaths were established against the background of COVID-19, who were prescribed 8 mg or 16 mg of dexamethasone and antibiotics during inpatient treatment according to the following schemes: penicillins + fluoroquinolones, fluoroquinolones, carbapenems.

The efficacy of early prescription of antibacterial drugs (penicillins + fluoroquinolones, fluoroquinolones) in critically ill and moderately severe patients requires further research. Criteria for prescribing antibiotic therapy should be developed.

Author Biographies

V. I. Trykhlib, Ukrainian Military Medical Academy

Doctor of Medical Sciences, Professor of the Department of Military Therapy of the Ukrainian Military Medical Academy

T. I. Lysenko, Ukrainian Military Medical Academy

lieutenant MS, student of the Ukrainian Military Medical Academy

A. O. Yeroshenko, Ukrainian Military Medical Academy

lieutenant MS, student of the Ukrainian Military Medical Academy

O. S. Martynchyk, Ukrainian Military Medical Academy

lieutenant MS, student of the Ukrainian Military Medical Academy

N. R. Tsiurak, Ukrainian Military Medical Academy

lieutenant MS, student of the Ukrainian Military Medical Academy

K. P. Bieliaieva, Ukrainian Military Medical Academy

lieutenant MS, student of the Ukrainian Military Medical Academy

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Published
2021-10-11
How to Cite
Trykhlib, V. I., Lysenko, T. I., Yeroshenko, A. O., Martynchyk, O. S., Tsiurak, N. R., & Bieliaieva, K. P. (2021). Effectiveness of antibiotic therapy in critically ill COVID-19 patients depending on age of patients and doses of hormonal drugs. Ukrainian Journal of Military Medicine, 2(3), 73-83. https://doi.org/10.46847/ujmm.2021.3(2)-073