The use of antibacterial preparations in COVID-19 patients

Abstract

SARS-CoV-2 which initially causes an acute respiratory infection with primary damage to the lungs, has shown that it later causes multiple lesions, being considered a systemic disease. Pneumonia caused by the coronavirus is characterized by the development of a marked inflammatory process by direct damage to the pulmonary alveolocytes, as well as by an imbalance of the innate and adaptive immune status, pro-inflammatory and anti-inflammatory cytokines and chemokines, coagulation and fibrinolysis processes. The empirical use of antibacterial preparations has shown an evolution depending on the epidemiological situation, the data of experimental and clinical studies and the accumulated experience. The excessive prescription of antibiotics was determined by of subjective reasons, and with the accumulation of data confirming coinfections and/‌or secondary infections, the administration of antibacterial preparations was redirected. Beta-lactams, macrolides and fluoroquinolones were the most prescribed antibacterial drugs, for which possible antiviral effects were also estimated (azithromycin etc.). The use of antibiotics from the surveillance and reserve groups, according to WHO policy, was one of the major problems during the pandemic due to the aspect of dangerous microbial resistance. The elucidation of the microbial agents involved in the etiology of bacterial infections in COVID-19 has allowed for a more targeted selection of antibiotics, including regarding the danger of threatening microbial resistance.