JMIR Publications

ABSTRACT

Background:

Ever since the first reports of COVID-19 infections across the world, the foremost requirement is to find a treatment regimen that not only fights off or kills the causative agent i.e., the SARS-COV-2 but also controls and treat the associated symptoms and complications of the infection. Due to time consuming process of drug discovery vaccine development, doctors used readily available drugs and therapies to control and treat the infections to minimize the death toll.

Objective:

To provide a snap-shot analysis of the major drugs used in a cohort of 1562 Pakistani patients during the May-July period when the first wave peaked in the country.

Methods:

A retrospective observational study providing an overview of basic treatments and major drugs used for in-hospital management of 1562 COVID-19 patients admitted to the four major tertiary-care hospitals in the Rawalpindi-Islamabad region of Pakistan was conducted in the period May 2020-July 2020.

Results:

Out of all the therapies employed antibiotics were the most common choice and used as the first line of treatment for COVID-19. Azithromycin was the most prescribed drug for the treatment. No trend was seen in the choice of antibiotics monthly and it seemed like a random but favorite choice throughout these months. It was also noted that 2nd and 3rd generation and even antibiotics used for Multidrug-resistant infections (MDR) were prescribed irrespective of the severity or progression of infections. This is alarming as it might lead to antibiotic resistance and liver damage in these patients whose immune system is already compromised because of the COVID-19 infection. A total of 1562 patients (68.1% males and 31.9% females) with a mean (SD) age of 47.35 (17.03) years were included in the study. The highest frequency of patient hospitalizations was in June (52.4%). Of the 19 drugs reportedly used for the treatment of COVID-19 and management of COVID-19-related symptoms, the five most frequently used drugs were antibiotics (Azithromycin (88.6%) and Ceftriaxone (23.6%)), anticoagulants (Heparin (21.6%) and Enoxaparin sodium (19.8%)) and corticosteroids (Hydrocortisone (25.7%).

Conclusions:

A targeted treatment regime or an efficient long-lasting vaccine is needed urgently to limit the misuse of antibiotics in the management of Coronavirus. As for the control of symptoms and related complications of the infection clear guidelines are needed for the type and dosage of antibiotics that should be used instead of the hit and trial method that is applied so far.