Abstract
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.
Highlights
COVID-19 infection cases and mortality in all countries are high, which has raised global awareness
This study aims to explore the effectiveness of various antibacterial and antiviral medications administered in the management of patients with COVID-19
Eighty percent of COVID-19 patients admitted to hospitals were aged 25–65 years, the number of mild-moderate patients was more than the number of severe patients, and the average length of stay was 8–13 days
Summary
COVID-19 infection cases and mortality in all countries are high, which has raised global awareness. Indonesia is the fourth most populous country in the world, and is predicted to suffer greatly and over a longer period compared to other less-populous countries. Indonesia has been greatly affected by COVID-19 with a Case Fatality Rate (CFR). Pathophysiology 2022, 29 of 8.9% at the end of March 2020 [1] in comparison to the global figure of 7.3% [2]. In Jakarta, the capital city of Indonesia, it has been reported that there were 4265 hospitalised patients with PCR-confirmed COVID-19 in 55 hospitals from the period of March to July 2020; 3768 (88%) were discharged and 497 (12%) died; 5% were children, the median age was 46 years (interquartile range: 32–57 years), and 31% had more than 1 reported comorbidity [3].
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