Abstract
The purpose of this study was to explore the value of using cefepime and ceftazidime in treating patients with COVID-19. A total of 370 (162 males) patients, with RT-PCR-confirmed cases of COVID-19, were included in the study. Out of them, 260 patients were treated with cefepime or ceftazidime, with the addition of steroids to the treatment. Patients were divided into three groups: Group 1: patients treated with cefepime (124 patients); Group 2: patients treated with ceftazidime (136 patients); Group 3 (control group): patients treated according to the WHO guidelines and the Egyptian COVID-19 management protocol (110 patients)/ Each group was classified into three age groups: 18–30, 31–60, and >60 years. The dose of either cefepime or ceftazidime was 1000 mg twice daily for five days. Eight milligrams of dexamethasone were used as the steroidal drug. Careful follow-ups for the patients were carried out. In vitro and in silico Mpro enzyme assays were performed to investigate the antiviral potential of both antibiotics. The mean recovery time for Group 1 was 12 days, for Group 2 was 13 days, and for Group 3 (control) was 19 days. No deaths were recorded, and all patients were recovered without any complications. For Group 1, the recovery time was 10, 12, and 16 days for the age groups 18–30, 30–60, and >60 years, respectively. For Group 2, the recovery time was 11, 13, and 15 days for the age groups 18–30, 30–60, and >60 years, respectively. For Group 3 (control), the recovery time was 15, 16, and 17 days for the age groups 18–30, 30–60, and >60 years, respectively. Both ceftazidime and cefepime showed very good inhibitory activity towards SARS CoV-2′s Mpro, with IC50 values of 1.81 µM and 8.53 µM, respectively. In conclusion, ceftazidime and cefepime are efficient for the management of moderate and severe cases of COVID-19 due to their potential anti-SARS CoV-2 activity and low side effects, and, hence, the currently used complex multidrug treatment protocol can be replaced by the simpler one proposed in this study.
Highlights
The whole world is confronting the COVID-19 (SARS CoV-2) pandemic
The patients were divided into two groups: Group 1: patients treated with cefepime (124 patients); Group 2: patients treated with ceftazidime (136 patients); Group 3: patients treated according to the WHO guidelines,. and the Egyptian COVID-19 management protocol [21], neither of which includes cefepime or ceftazidime (110 patients)
The younger patients have a lower risk of developing into severe cases and recover from COVID-19 symptoms faster than older patients
Summary
The whole world is confronting the COVID-19 (SARS CoV-2) pandemic This virus is highly infectious, with a high morbidity rate [1]. The use of antibiotics with COVID-19 patients is still controversial, they have shown considerable therapeutic benefits, with patients with severe pneumonia or those receiving glucocorticoids or other immunosuppressant therapeutics [13,14,15,16]. Another major concern of the uncontrolled use of antibiotics is the subsequent rapid development of resistance [17,18]. Using a limited number of already available antibiotics that Antibiotics 2021, 10, x FOR PEER REVIEWcan exert antiviral activity against SARS CoV-2 will have great potential in im3proof v1i2ng the recovery rate of COVID-19 patients and slowing down the emergence of antibiotics resistance
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