Comparative Analysis of Clinical Outcomes of COVID-19 Patients With and Without Antibiotic Administration: A Randomized Clinical Trial

Background and aims: Antibiotics are essential for confirmed bacterial infections associated with coronavirus disease 2019 (COVID-19). However, their efficacy in improving the clinical course of the disease without a concomitant bacterial infection has not been established. Thus, this study aimed to evaluate the effectiveness of antibiotic treatment on the clinical course of COVID-19, thereby increasing the credible evidence produced by randomized clinical trials on the efficacy of antibiotics for managing COVID-19. Methods: In general, 90 patients with COVID-19 were randomly assigned to either an intervention or the control group. Cephalosporins and fluoroquinolones were administered for a period of five days. Laboratory factors and the disease course were determined for both groups. The data were analyzed using SPSS 26. Results: Intragroup comparisons of the mean erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) in both groups were significantly lower on day 7 than on day 1 (P<0.001), but the mean ferritin did not change significantly (P=0.071). However, the mean oxygen saturation, respiration rate, and fever in both groups improved significantly by days 7 and 14 compared to day 1 (P<0.001). In the intergroup comparison, changes in the oxygen saturation, ferritin, CRP, and ESR were not significantly different between groups. Likewise, the prevalence of fever and respiratory rate did not significantly differ between groups on days 1, 7, and 14. Conclusion: Antibiotics had no significant effect on the clinical course and laboratory parameters of patients with COVID-19. Accordingly, they are not recommended except in cases of concomitant bacterial infections.