Empirical Piperacillin/Tazobactam versus Imipenem/Cilastatin in Covid-19 Infected Patients

Background/Aim: β-Lactam/β-lactamase inhibitors (BL/BLIs) and carbapenems are often considered for the treatment of sepsis when the main suspected pathogens are Gram-negative bacteria, because of their broad spectrum of coverage. Our aim was to compare the clinical outcomes of the two most widely used empirical broad-spectrum antibiotics in Jordanian SARS-CoV-2 infected patients. Methods: A single-center, retrospectively study was conducted in a specialized COVID-19 isolation center at Queen Alia Military Hospital of the Royal Medical Services (RMS) in Jordan. Over 19 months. All Jordanian mild/moderate-severe/critical SARS-CoV-2 infected patients aged 18 years and above, whose hospital admission days exceeded at least 3 days, and whose COVID-19 diagnosis were suspected or confirmed were included in our study. β-ABs were allocated to Non-PIP/TAZ group (Group I) and PIP/TAZ group (Group II). An Independent T and One –Sample T Tests, and Chi Square Test will be used to analyze the parametric and non-parametric outcomes’ data, respectively. Results: 718 eligible studied patients were finally included in this study (718/4183, 18.67%) in which 247 patients (31.6%) had suspected COVID-19 infection and 534 (68.4%) had confirmed COVID-19 infection. The mean age of the whole study cohort was 59.40±10.60. Insignificantly, males were distributed in the study in approximately 2.309:1 ratio compared to females. The main finding of our study was that an investigated overall 28-day SARS-CoV-2 infected patients’ mortality were insignificantly recorded between the two ABs based categorized cohorts [75 (19.8%) vs 80 (19.9%), p-Value=0.997] over also insignificantly overall hospital length of stay (LOS) [11.17±2.79 days vs 11.28±2.91 days, -0.11±0.20 days, p-Value=0.595] for Cohort I and Cohort II, respectively. Conclusion: In summary, our results demonstrate that there were insignificant differences between Piperacillin/Tazobactam and Carbapenems regarding overall clinical impacts, when they were empirically administered in SARS-CoV-2 infected patients. Also, we explored that significant higher %cNa12 in PIP/TAZ Cohort (Cohort II) may have positive clinical advantages over Carbapenems in Non-PIP/TAZ (Cohort I).