Eid Ragaey A, Elgendy Marwa O, El-Gendy Ahmed O, Elgendy Sara O, Belbahri Lassaad, Sayed Ahmed M, Rateb Mostafa E
Department of Tropical Medicine, Faculty of Medicine, Beni-Suef University, Beni-Suef 62521, Egypt.
Department of Clinical Pharmacy, Teaching Hospital of Faculty of Medicine, Faculty of Medicine, Beni-Suef University, Beni-Suef 62514, Egypt.
Antibiotics (Basel). 2021 Oct 20;10(11):1278. doi: 10.3390/antibiotics10111278.
The purpose of this study was to explore the value of using cefepime and ceftazidime in treating patients with COVID-19. A total of 370 (162 males) patients, with RT-PCR-confirmed cases of COVID-19, were included in the study. Out of them, 260 patients were treated with cefepime or ceftazidime, with the addition of steroids to the treatment. Patients were divided into three groups: Group 1: patients treated with cefepime (124 patients); Group 2: patients treated with ceftazidime (136 patients); Group 3 (control group): patients treated according to the WHO guidelines and the Egyptian COVID-19 management protocol (110 patients)/ Each group was classified into three age groups: 18-30, 31-60, and >60 years. The dose of either cefepime or ceftazidime was 1000 mg twice daily for five days. Eight milligrams of dexamethasone were used as the steroidal drug. Careful follow-ups for the patients were carried out. In vitro and in silico M enzyme assays were performed to investigate the antiviral potential of both antibiotics. The mean recovery time for Group 1 was 12 days, for Group 2 was 13 days, and for Group 3 (control) was 19 days. No deaths were recorded, and all patients were recovered without any complications. For Group 1, the recovery time was 10, 12, and 16 days for the age groups 18-30, 30-60, and >60 years, respectively. For Group 2, the recovery time was 11, 13, and 15 days for the age groups 18-30, 30-60, and >60 years, respectively. For Group 3 (control), the recovery time was 15, 16, and 17 days for the age groups 18-30, 30-60, and >60 years, respectively. Both ceftazidime and cefepime showed very good inhibitory activity towards SARS CoV-2's M, with IC values of 1.81 µM and 8.53 µM, respectively. In conclusion, ceftazidime and cefepime are efficient for the management of moderate and severe cases of COVID-19 due to their potential anti-SARS CoV-2 activity and low side effects, and, hence, the currently used complex multidrug treatment protocol can be replaced by the simpler one proposed in this study.
本研究的目的是探讨使用头孢吡肟和头孢他啶治疗新型冠状病毒肺炎（COVID-19）患者的价值。本研究共纳入370例（162例男性）经逆转录聚合酶链反应（RT-PCR）确诊的COVID-19患者。其中，260例患者接受了头孢吡肟或头孢他啶治疗，并在治疗中加用了类固醇。患者分为三组：第1组：接受头孢吡肟治疗的患者（124例）；第2组：接受头孢他啶治疗的患者（136例）；第3组（对照组）：根据世界卫生组织（WHO）指南和埃及COVID-19管理方案进行治疗的患者（110例）。每组又分为三个年龄组：18 - 30岁、31 - 60岁和>60岁。头孢吡肟或头孢他啶的剂量均为每日两次，每次1000 mg，共五天。使用8毫克地塞米松作为类固醇药物。对患者进行了仔细的随访。进行了体外和计算机模拟M酶测定，以研究这两种抗生素的抗病毒潜力。第1组的平均恢复时间为12天，第2组为13天，第3组（对照组）为19天。无死亡记录，所有患者均康复且无任何并发症。对于第1组，18 - 30岁、30 - 60岁和>60岁年龄组的恢复时间分别为10天、12天和16天。对于第2组，18 - 30岁、30 - 60岁和>60岁年龄组的恢复时间分别为11天、13天和15天。对于第3组（对照组），18 - 30岁、30 - 60岁和>60岁年龄组的恢复时间分别为15天、16天和17天。头孢他啶和头孢吡肟对严重急性呼吸综合征冠状病毒2（SARS CoV-2）的M均表现出非常好的抑制活性，IC值分别为1.81 μM和8.53 μM。总之，头孢他啶和头孢吡肟因其潜在的抗SARS CoV-2活性和低副作用，对COVID-19的中重症治疗有效，因此，目前使用的复杂多药治疗方案可被本研究提出的更简单方案取代。
