• O.A. Savchenko State Institution «Zaporizhzhia Medical Academy of post-graduate education Ministry of Health of Ukraine», Zaporizhzhia, Ukraine
  • S.L. Podsevahyna State Institution «Zaporizhzhia Medical Academy of post-graduate education Ministry of Health of Ukraine», Zaporizhzhia, Ukraine
  • A.V. Tkachenko State Institution «Zaporizhzhia Medical Academy of post-graduate education Ministry of Health of Ukraine», Zaporizhzhia, Ukraine
  • D.P. Myrnyi State Institution «Zaporizhzhia Medical Academy of post-graduate education Ministry of Health of Ukraine», Zaporizhzhia, Ukraine
  • Y.V. Katsiuba State Institution «Zaporizhzhia Medical Academy of post-graduate education Ministry of Health of Ukraine», Zaporizhzhia, Ukraine
  • A.I. Myrna National University "Zaporizhzhia Polytechnic"
Keywords: covid-associated community-acquired pneumonia, antibiotic therapy


Introduction. The advent of the COVID-19 pandemic has posed challenges to healthcare professionals. The most common manifestation of a new variant of coronavirus disease is pneumonia, and therefore, the doctor is faced with the question of the diagnostic value of certain indicators, as well as - the feasibility of prescribing antibacterial therapy.

The purpose of the study was to assess the importance of clinical, imaging, laboratory methods for diagnosing the condition of patients with covid-associated pneumonia, to determine the nuances of the possible appointment of antibacterial therapy.

Current text. The main problem in the diagnosis of covid-associated pneumonia is the need to differentiate between viral lung disease and the development of secondary bacterial pneumonia. Viral pneumonia can be of varying severity, but does not require antibacterial therapy. At the same time, the accession of bacterial flora on the background of viral lung disease, requires the immediate appointment of antibacterial drugs. It should be noted that the available data to date indicate that the accession of bacterial infection to viral lung disease is confirmed in no more than 8-10% of patients, ie most patients with coronavirus do not require antibiotics [1,2, 3]. At the same time, worldwide, antibiotics associated with pneumonia-associated pneumonia are unreasonably common and, according to some studies, the proportion of patients receiving antibacterial therapy ranges from 27% to 84% [1,4,5].

Conclusions. The problem of managing patients with covid-associated pneumonia is due to the fact that, to date, there is no specific criterion that would clearly distinguish viral lung disease from viral-bacterial. Traditionally, data from clinical, laboratory and instrumental research methods are used for the differential diagnosis of viral and bacterial pneumonia. A common approach to antibiotic treatment in many cases is not only unjustified, but also leads to a massive increase in antibiotic resistance with subsequent complications. In each case, the decision must be made individually, taking into account the full range of diagnostic and clinical aspects.


Rawson TM, Moore LS, Zhu N. et al. Bacterial and Fungal Coinfection in individuals with coronavirus: A rapid review to support COVID-19 antimicrobial prescribing. Clin. Infect. Dis. 2020; 71 (9): 2459–2468.

Hughes S, Troise O, Donaldson H, et al. Bacterial and fungal coinfection among hospitalized patients with COVID-19: a retrospective cohort study in a UK secondarycare setting/S. Hughes,. Clin. Microbial. Infect. 2020; 26 (10): 1395–1399.

Lansbury L. Co-infections in people with COVID-19: a systematic review and metaanalysis. J Infect. 2020; 81 (2): 266–275.

Vaughn VM. Empiric antibacterial therapy and community-onset bacterial co-infection in patients hospitalized with COVID-19: a multihospital cohort study.Clin. Infect. Dis. 2021; May 18: 72 (10): 533–541.

Langford BJ. Bacterial co-infection and secondary fection in patients with COVID-19: a living rapid review and meta-analysis.Clin. Microbiol. Infect. 2020; Dec; 26 (12): 1622–1629.

Wang D. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirusinfected pneumonia in Wuhan, China. JAMA. 2020; 323 (11) 1061–1069.

Sun P. Clinical characteristics of hospitalized patients with SARS-CoV-2 infection. A single meta-analysis. J. Med. Virol. 2020; Jun; 92 (6): 612–617.

Belevskij AS. Algoritm naznacheniya antibakterialnoj terapii pri SARS-Cov-2- associirovannyh povrezhdeniyah lyogkih u pacientov s COVID-19. Metodicheskie rekomendacii.M.: 2020:12 s.

Huang C. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020; 395 (10223): 497–506.

Kouhsari E. Clinical, epidemiological, laboratory, and radiological haracteristics of novel Coronavirus (2019-nCoV) in retrospective studies: A systemic review and meta-analysis.Indian J. Med. Microbiol. 2021; Jan; 39 (1): 104–115.

Feshenko YuI, Belosludceva KO, Golubovska OA, ta in Negospitalna pnevmoniya u doroslih osib: etiologiya, patogenez, klasifi kaciya, diagnostika, antimikrobna terapiya ta profilaktika. Adaptovana klinichna nastanova, zasnovana na dokazah. K. 2019; 94 s.

Basarab M, Macrae MB, Curtis CM. Atypical pneumonia. Curr. Opin. Pulm. Med. 2014; 20 (3): 247–251.

Cilloniz C. Community-acquired pneumonia related to intracellular pathogens.Intensive Care Med. 2016; 42 (9):86 137.

Mason CY. Exclusion of bacterial co-infection in COVID-19 using baseline inflammatory markers and their response to antibiotics.J. Antimicrob. Chemother. 2021; 76 (5): 1323–1331.

Gao Y. Diagnostic utility of clinical laboratory data determinations for patients with the severe COVID-19.J. Med. Virol. 2020; 92 (7): 791–796.

Tan C, Huang Y, Shi F et al. C-reactive protein correlates with computed tomographic findings and predicts severe COVID-19 early. J. Med. Virol. 2020; 92 (7): 856–862.

Wan S. Clinical features and treatment of COVID-19 patients in northeast Chongqing. J. Med. Virol. 2020; 92 (7): 797–806.

Nakaz MOZ Ukrayini № 638. Protokol nadannya medichnoyi dopomogi dlya likuvannya koronavirusnoyi hvorobi (COVID-19). Vid 06.04.2021 r.

Linscheid P. In vitro and in vivo calcitonin I gene expression in parenchymal cells: a novel product of human adipose tissue.Endocrinology. 2003; Dec; 144 (12): 5578–84.

Wolfisberg S. Procalcitonin for individualizing antibiotic treatment: an update with a focus on COVID-19. Review Crit Rev Clin Lab Sci. 2022; Jan; 59 (1): 54–65.

Williams EJ, Mair L, de Silva TJ, et al Evaluation of procalcitonin as a contribution to antimicrobial stewardship in SARS-CoV-2 infection: a retrospective cohort study. J. Hosp. Infect. 2021; 110: 103–107.

Covington E, Megan Z, Roberts I, Dong J. Procalcitonin Monitoring as a Guide for Antimicrobial Therapy: A Review of Current Literature. Review Pharmacotherapy. 2018; May; 38 (5): 569–581.

Gavrilov PV, Lukina OV, Smolnikov UA, Korobejnikov SV. Rentgenologicheskie izmeneniya v lyogkih, svyazannye s novoj koronavirusnoj infekciej. Luchevaya diagnostika, 2020;2 (11): 29–36.

Jacobi А, Chung M, Bernheim A, Eber C. Portable chest X-ray in coronavirus disease-19 (COVID-19: A pictorial review. Clinical Imaging. 2020;64:35–42.

Yudin AL. Aspects of computed tomography in diagnostics of organizing pneumonia. REJR. 2019; 9 (3): 176–189.

Ng W, Lee E, Yang J, et al. Imaging profile of the COVID-19 infection: radiologic findings and literature review. Radiol Cardiothorac Imaging. 2020;2 (1): 58–72.

Tao Ai. Correlation of chest CT and RT-PCR testing in coronavirus disease 2019 (COVID-19) in China: A report of 1014 cases.Radiology. 2020; 296 (2): 32–40.

Salehi S, Abedi A, Balakrishnan S, et al. Coronavirus disease 2019 (COVID-19): a systematic review of imaging findings in 919 patients.J. Roentgenol. 2020;(14): 1–7.

Feshenko YuI. Osoblivosti urazhennya legen pri COVID-19. Ukr. pulmonologichnij zhurnal, 2021;1: 5–12.

Song F, Shi N, Shan F, et al. Emerging novel coronavirus (2019-nCoV) pneumonia. Radiology. 2020; 295: 210–217.

Hani C. COVID-19 pneumonia: A review of typical CT findings and differential diagnosis. Diagn Interv Imaging. 2020; 101 (5): 263–268.

Rekomendacii VOZ. Klinicheskoe vedenie sluchaev COVID-19. Variativnye rekomendacii. Versiya ot 25.01.2021 g.109 s.

Lai CC, Wang CY, Hsueh PR. Co-infections among patients with COVID-19: The need for combination therapy with non-anti-SARS-CoV-2 agents?. Microbiol Immunol Infect. 2020; 53 (4): 505–512.

Hoque MN. Microbial co-infections in COVID-19: Associated microbiota and underlying mechanisms of pathogenesis. Hoque et al. Review Microb Pathog. 2021; 156: 104941.

Sharov KS. SARS-CoV-2-related pneumonia cases in pneumonia picture in Russia in March- May 2020: Secondary bacterial pneumonia and viral co-infections. J Glob Health. 2020; 10 (2): 020504.

Russell CD. Co-infections, secondary infections, and antimicrobial use in patients hospitalised with COVID-19 during the first pandemic wave from the ISARIC WHOCCP-UK study: a multicentre, prospective cohort study. Lancet Microbe. 2021; 2 (8): 354–365.

Karageorgopoulos ED. Fluoroquinolones compared with beta-lactam antibiotics for the treatment of acute bacterial sinusitis: a meta-analysis of randomized controlled trials. CMAJ. 2008;178 (7): 845–854.

Feshhenko JuI, Dzjublyk OJa. Negospital'na pnevmonija, asocijovana z COVID-19:pogljad na likuvannja.. Ukrai'ns'kyj pul'monologichnyj zhurnal, 2020;2:5–12.

Buetti N. Early administered antibiotics do not impact mortality in critically ill patients with COVID-19. J Infect. 2020; 81 (2): 148–149.

Aldeyab MA. A point prevalence survey of antibiotic use in four acute-care teaching hospitals utilizing the European Surveillance of Antimicrobial Consumption (ESAC) audit too. Epidemiol. Infect. 2012; 140 (9): 1714–20.

Huttner B. COVID-19: don’t eglect antimicrobial stewardship principles!. Clin Microbial Infect. 2020; 26 (7): 808–810.

How to Cite
Savchenko, O., Podsevahyna, S., Tkachenko, A., Myrnyi, D., Katsiuba, Y., & Myrna, A. (2022). PROBLEMS OF ANTIBIOTIC THERAPY IN KOVID-ASSOCIATED HOSPITAL PNEUMONIA. Modern Medical Technology, (2(53), 30-35.
Original research