The clinical manifestations associated with COVID-19 disease is mainly due to a dysregulated host response related to the overexpression of inflammatory markers. Until recently, only remdesivir had gained FDA approval for COVID-19 hospitalized patients and there are currently no evidence-based therapeutic options or options for prevention of complications that have been established. Some medical treatments such as antivirals, antibacterials, antithrombotics, antipyretics, corticosteroids, interleukin inhibitors, monoclonal antibodies, convalescent plasma, immunostimulants, and vitamin supplements have been utilized. However, there are limited data to support their effectiveness. Hence, this study was attempted to identify and evaluate the effectiveness of antibacterials and antivirals used for COVID-19 using a retrospective cross-sectional approach based on the medical records of adult patients in four hospitals. The number of antibacterials was calculated in defined daily dose (DDD) per 100 bed-days unit. Both mixed-logit regression and analysis of covariance were used to determine the effectiveness of the aforementioned agents in relation to COVID-19 outcome and patients’ length of stay. The model was weighed accordingly and covariates (e.g., age) were considered in the model. Heart disease was found to be the most common pre-existing condition of COVID-19 hospitalized patients in this study. Azithromycin, an antibacterial in the Watch category list, was used extensively (33–65 DDD per 100 bed-days). Oseltamivir, an antiviral approved by the FDA for influenza was the most prescribed antiviral. In addition, favipiravir was found to be a significant factor in improving patients’ COVID-19 outcomes and decreasing their length of stay. This study strongly suggests that COVID-19 patients’ received polypharmacy for their treatment. However, most of the drugs used did not reach statistical significance in improving the patients’ condition or decreasing the length of stay. Further studies to support drug use are needed.
Background: COVID-19 is an infectious disease caused by a new type of virus named SARS-CoV-2. There is still no specific treatment for COVID-19; the antibiotic is used for therapy and to prevent severe disease, so the increasing use of antibiotics in COVID-19 patients will lead to a detrimental impact and the risk of antibiotic resistance. Purpose: This study aims to analyze antibiotic use frequency and determine the number of DDD per 100 bed-days in July – December 2020 at Bhayangkara Hospital Surabaya. Methods: This research was a descriptive study with a retrospective study design conducted at Bhayangkara Hospital Surabaya in May – June 2021. The data were collected from 94 medical records, inclusion criteria: all ages; asymptomatic, mild, and moderate categories; all hospitalized patients in July-December 2020 who received antibiotics; the exclusion criteria: non-confirmed COVID-19 patients who had comorbidities and received antibiotics; the patient who died. The variables: frequency of antibiotic use with calculating the number of DDD/100 bed-days and percentage of COVID-19 patients who received antibiotics during hospitalization. Results: The frequency of antibiotic use in asymptomatic, mild, and moderate COVID-19 patients: 86.56 DDD/100 bed-days, the most antibiotic use was azithromycin at 50.42 DDD/100 bed-days and Levofloxacin at 22.70 DDD/100 bed-days. All asymptomatic, mild, and moderate COVID-19 patients (100%) at Bhayangkara Hospital Surabaya were treated with antibiotics, whereas the condition of patients was 5.32% asymptomatic, 48.94% mild, and 45.74% moderate. Conclusion: There is overuse of antibiotics in asymptomatic, mild and moderate COVID-19 patients at Bhayangkara Hospital Surabaya.
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