The effect of levofloxacin combinations on CRP decrease in SARS CoV-2 pneumonia

Abstract

Objective:Covid 19 pneumonia, caused by the SARS-CoV-2 virus, is a disease with severe damage to the lung.It was reported that in Covid 19, rate of 74% antibiotics were used, and secondary bacterial infections were detected in at least 17.6% of the patients who used antibiotics. In this study, the effects of antibiotics in Covid 19 patients who do not use steroid ​​on CRP decrease were aimed. Materials and Methods:It was done in Ersin Arslan Training and Research Hospital Covid Wards between January 1, 2020 and December 31, 2020. The study included with positive PCR test, 18 age and more than, had normal WBC value, with pneumonia in CT, and use of steroid were excluded.Patients' age, gender, comorbidity, CRP values ​​in the first 24 hours and the 3rd day, antibiotic use, pathological foci on the lung in CT investigated.Accordingly, a total of 202 patients who compatible criteria were included in the study. Chi Square Test was used in the statistical analysis of the data. Results:The mean age was 60.2±2.57 (19-89). 53.9% of the patients were male and 46.1% female.There was a history of chronic disease in 54.9% of the patients. Findings of pneumonia in CT were 67.8% multifocal and 32.2% unifocal.Antibiotics used were levofloxacin and combined levofloxacin with piperacillin/tazobactam or meropenem or ceftriaxone. When the 1st and 3rd day CRP values ​​were compared; as L<LT<LM<LC rate of decrease were calculated. Conclusion:According to this study in Covid 19 pneumonia; the combination of levofloxacin with ceftriaxone or meropenem may be preferred as empiric antibiotics in patients 40 age and younger and had comorbidities.The combination of levofloxacin with piperacillin/ tazobactam may be preferred as an empirical antibiotic in patients with multifocal pneumonia in CT. There is no significant difference with the decrease on CRP value among prophylactic antibiotics.Therefore, levoflaxacin alone should be preferred as a prophylactic antibiotic.