The Safety of Co-Administration of Antibiotics with Lopinavir/Ritonavir for COVID-19 Patients: A Retrospective Comparative Single-Center Study in Makkah
Year: 2024
Type: article
Study design: Observational Study
Abstract: Background:-SARS-CoV-2 triggered the COVID-19 pandemic, which resulted in millions of illnesses and deaths globally. A complex secondary respiratory bacterial infection is often associated with COVID-19. We administer antibiotics for COVID-19-related bacterial infections. The side effects and toxicities of selected antibacterial medicines for treating bacterial infections in COVID-19 patients need to be evaluated, as the safety of administering these drugs in COVID-19 is unknown. Widespread use during the pandemic raises concerns about side effects and drug interactions, highlighting the need for careful evaluation. Methods:-A total of 130 patients admitted to King Faisal Hospital in Makkah, Saudi Arabia, were included in this study. All patients received antiviral therapy with lopinavir and ritonavir, alongside antibacterial treatments, including azithromycin, vancomycin, and levofloxacin. Key laboratory parameters such as white blood cell count, hemoglobin, creatine kinase, liver enzymes, serum creatinine, blood urea nitrogen, lactate dehydrogenase, albumin, and bilirubin were measured upon admission and reassessed after 2–3 weeks of hospitalization. Results:-The administration of azithromycin led to increases in white blood cell count, liver enzymes, alkaline phosphatase, blood urea nitrogen, and bilirubin levels, while reducing hemoglobin and albumin levels. Levofloxacin significantly decreased albumin and hemoglobin levels but caused no notable changes in other parameters. Vancomycin slightly reduced hemoglobin and albumin levels while increasing liver enzymes, serum creatinine, and blood urea nitrogen. Co-administration of lopinavir/ritonavir with antibiotics markedly amplified these side effects across the test-ed parameters. Conclusion:-Azithromycin, when combined with lopinavir and ritonavir to treat secondary pulmonary bacterial infections in COVID-19 patients, may heighten the risk of renal and hepatotoxicity. Daily administration of vancomycin posed a moderate risk of nephrotoxicity, whereas levofloxacin demonstrated the lowest overall risk among the antibiotics studied. These findings emphasize the need for careful antibiotic selection to reduce renal and hepatic risks in future pandemics.
DOI: 10.54940/ms59217418
Authors: Alshaymaa Simsim, Safaa Eid
Institutions: Umm al-Qura University, Saudi Toxicology Society
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4407138689