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 the 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 (SARS-CoV-2), 18 age and more than, with pneumonia in CT, but users of steroid  were excluded. Ages, genders, comorbidities, WBC values, neutrophil values, CRP values (​​in the first 24 hours and the 3rd day), lung involvements in CT and antibiotics ​​of the patients were analyzed retrospectively. 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 males and 46.1% females. 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. Covid 19 pneumonia was more often in males, in over 60 ages and in have a history of chronic disease. Antibiotics used were levofloxacin (L) and combined levofloxacin with piperacillin/tazobactam (LT) and meropenem (LM) and ceftriaxone (LC). When the 1st and 3rd day CRP values ​​were compared; as L<LT<LM<LC rate of decrease were calculated. It was determined that LM and LC were preferred more often in patients with comorbidities. There was no statistically significant difference between the rates of decrease on CRP values ​​of levofloxacin and its combinations in patients with normal WBC values. Conclusion: According to this study, in SARS-CoV-2 pneumonia; there is no significant difference between the rates of decrease on CRP values ​​of levofloxacin and its combinations. Antibiotics should be preferred if bacterial infection is suspected when the patient's clinic and infection parameters are evaluated. It should be taken into account that secondary coinfection rates are not high in the selection of antibiotics in Covid 19. Further studies are needed to detect bacterial coinfections early in patients.