Dedic Vedad, Sljivo Armin, Arnautovic Alen, Mulac Ahmed
Health Center of Sarajevo Canton, Sarajevo, Bosnia and Herzegovina.
Emergency Medical Service of Canton Sarajevo, Sarajevo, Bosnia and Herzegovina.
Mater Sociomed. 2022 Jun;34(2):112-117. doi: 10.5455/msm.2022.34.112-117.
COVID-19 has different presentations from mild flu like symptoms such as anosmia, dysgeusia, fever, sore throat, cough, dyspnea, headache, abdominal pain and diarrhoea to severe COVID-19 with the development of acute respiratory syndrome (ARDS), septic shock, metabolic acidosis, coagulation dysfunction, multiorgan failure or even death.
The aim of this research project was to present and highlight the outcomes of the vaccination against COVID-19 and the widespread use of antibiotics during the initial admission and treatment of COVID-19 patients in out of hospital settings.
This observational cross-sectional study was conducted between September 1st and September 24th 2021, during the fourth wave of COVID-19 outbreak in Bosnia and Herzegovina, among the patients admitted to the primary health care COVID-19 centre of Canton Sarajevo in Bosnia and Herzegovina.
Patients were mostly female 213 (53.3%), with a mean age of 48.8±18.6, with hypertension 129 (32.3%) or diabetes mellitus 35 (8.7%) as comorbidities and being COVID-19 unvaccinated 236 (59.0%) COVID-19 unvaccinated patients expressed more fever ( =9.93, p<0.05), had typical COVID-19 chest X ray presentation ( =6.08, p<0.05) and abnormal lung auscultation sounds ( =5.43, p<0.05). Out of all patients, 312 (78.0%) have received antibiotics and 3 (0.75%) antivirotics such as favipiravir as therapy for the treatment of COVID-19. The mean duration of the antibiotic regime was 10.2 ± 7.5 days with a minimum of 3 days and maximum of 62 days. The minimum CRP value when antibiotics were prescribed was 0.1 (ref. value <5mg/l). The most prescribed antibiotic was doxycycline 172 (43.0%), followed by ceftriaxone 139 (34.7%) and azithromycin 108 (27.0%).
Our study showed that vaccination acts protective for the development of severe COVID-19 forms, as well as that antibiotics were overused among COVID-19 infected. The outcome of such malpractice could lead to antimicrobial resistance which will be seen in further years. Governmental agencies should advise physicians to change these trends.
新型冠状病毒肺炎（COVID-19）有不同的表现，从类似流感的轻微症状，如嗅觉丧失、味觉障碍、发热、咽痛、咳嗽、呼吸困难、头痛、腹痛和腹泻，到发展为急性呼吸窘迫综合征（ARDS）、感染性休克、代谢性酸中毒、凝血功能障碍、多器官功能衰竭甚至死亡的重症COVID-19。
本研究项目的目的是展示并强调COVID-19疫苗接种的结果以及在COVID-19患者院外初始入院和治疗期间抗生素的广泛使用情况。
本观察性横断面研究于2021年9月1日至9月24日在波斯尼亚和黑塞哥维那COVID-19疫情第四波期间，对波斯尼亚和黑塞哥维那萨拉热窝州初级卫生保健COVID-19中心收治的患者进行。
患者以女性居多，共213例（53.3%），平均年龄48.8±18.6岁，合并高血压129例（32.3%）或糖尿病35例（8.7%），未接种COVID-19疫苗的患者有236例（59.0%）。未接种COVID-19疫苗的患者发热更多（ =9.93，p<0.05），有典型的COVID-19胸部X线表现（ =6.08，p<0.05）和肺部听诊异常（ =5.43，p<0.05）。在所有患者中，312例（78.0%）接受了抗生素治疗，3例（0.75%）接受了抗病毒药物如法匹拉韦作为COVID-19的治疗。抗生素治疗的平均疗程为10.2±7.5天，最短3天，最长62天。开始使用抗生素时的最小C反应蛋白（CRP）值为0.1（参考值<5mg/l）。最常开具的抗生素是多西环素172例（43.0%），其次是头孢曲松139例（34.7%）和阿奇霉素108例（27.0%）。
我们的研究表明，疫苗接种对重症COVID-19的发展具有保护作用，同时COVID-19感染者中抗生素存在过度使用的情况。这种不当行为的后果可能导致抗菌药物耐药性，这将在未来几年显现出来。政府机构应建议医生改变这些趋势。
