PHARMACOLOGICAL ASSISTANCE FOR PATIENTS WITH COMMUNITY-ACQUIRED PNEUMONIA CAUSED BY COVID-19
DOI:
https://doi.org/10.32782/health-2023.4.19Keywords:
community-acquired pneumonia, SARS-CoV2, COVID-19, antimicrobial therapy, corticosteroids, antiviral agentsAbstract
The aim of our review was to assess the impact of various drugs on the treatment of community-acquired pneumonia caused by SARS-CoV2 using updated clinical trials, and analyzing current scientific sources of information on this topic. Among the main groups of drugs, antiviral, antibacterial, and hormonal drugs are the leaders in the treatment of community-acquired pneumonia caused by SARS-CoV2. In outpatients without comorbidities, if pneumococcal resistance to macrolides exceeds 25%, treatment options often include β-lactams such as amoxicillin plus azithromycin or doxycycline used alone. For patients with concomitant pathologies, combined therapy with β-lactam and macrolides or doxycycline, or monotherapy with “respiratory” fluoroquinolones, can be used. In patients with a mild course of the disease, the initial treatment usually consists of a combination of a β-lactam, for example, ceftriaxone with a macrolide, or monotherapy with “respiratory” fluoroquinolones. For confirmed NP due to COVID-19, dexamethasone 6 mg IV or oral or its equivalent dose of other forms of corticosteroids for 10 days or until hospital discharge is recommended in patients with low saturation because it reduces mortality. An increase in the benefit of the drug was noted with increasing severity of the course of the disease. Remdesivir 200 mg IV as a single dose, then 100 mg daily for 4 days, shortens recovery time and can be used alone for those with lower oxygen needs and who do not require mechanical ventilation. Dexamethasone can also be combined with remdesivir. However, it is important to understand that decisions regarding the specifics of treatment for community-acquired pneumonia in the context of COVID-19 should be made on an individual basis. The physician must consider the clinical, epidemiological, and diagnostic parameters associated with each patient and be prepared to reassess and modify therapy, if necessary, based on the clinical course and results of diagnostic testing.
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