الفهرس 
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Abstract
Wahan city was the center of COVID-19 spread worldwide. It was first discovered in December 2019 in a group of people in the Fish market in China. In 2020 CDC and WHO declared the COVID-19 pandemic. Neither specific medication nor vaccine was discovered until 2021.It was known bacterial coinfection occurs with certain viruses as Influenza viruses. So, it was supposed that it occurred with covid also. But antibiotics with wide spectrum were prescribed that might be a threat to humans due to the appearance of resistant strains of bacteria that might not respond to any antibiotic and leads to the return of the pre-antibiotic era. Accordingly, antibiotics should be prescribed based on culture results and with the narrowest spectrum.
Primarily, the Ministry of Health established a treatment protocol that included regimens according to the severity of the case. It was updated periodically according to treatment plans worldwide. Antibiotics that aren’t used in viral infections were prescribed by physicians, especially in ICU patients due to the fear of development of bacterial infection.
The present study aimed to show the pattern of antibiotic use and bacterial co-infection in hospitalized covid-19 patients. The study was conducted in Alexandria Main University Hospital on 121 patients from (June 2021- February 2022) admitted to the ICU with signs and symptoms of COVID-19.
Ethical approval from MRI and AMUH were obtained before starting the study. Demographic data were collected, and laboratory results of the patients were. Cultures were withdrawn on admission and day 10 follow up. Patients have been diagnosed clinically with COVID-19 and confirmed by PCR.
The mean age of the participants was (64.7 ±14.7), (47.2%) of them were females while (52.8%) were males. Among the patients (51.3%) of them were discharged while (48.7%) died at day 10. Fifty-nine of them needed intubation (mechanical ventilation) with a percentage (48.7%). Only one patient received the COVID vaccine before admission to the ICU. The most common co-morbidity found among patients was HTN (hypertension) (24.8%) followed by DM (diabetes mellitus) (21.3%).
The pattern of antibiotics prescribed to patients during ICU stays. The most prescribed antibiotic was Levofloxacin (21.1%) then Meropenem (17.8%) then Linezolid (16.6%). Dual or triple antibiotic therapy was prescribed to patients (combined regimens) mostly (Levofloxacin and Linezolid). Antiviral drugs such as (Remdesivir, Ivermectin, and colchicine, Perfinix) were prescribed to 101 patients with a percentage of (83.4%). Sarilumab (Kevzara®) was prescribed to 6 patients with a percentage of (4.95%). Bevacizumab was prescribed to one patient and Tocilizumab (Actemra®) was prescribed to five patients. Corticosteroids (Dexamethasone, solumedrol, and hydrocortisone) were prescribed to (91.7%) of patients.