Influence of antibiotic therapy on indicators of endotoxinemia and systemic inflammation in acute SARS-CoV-2 lung damage

Background . Prescribing antibacterial drugs for the treatment of a new coronavirus infection at the outpatient stage is often unreasonable and can also lead to an aggravation of the patient’s condition due to the effect of this group of drugs on the intestinal microflora and lead to other undesirable effects. The aim : to assess the level of lipopolysaccharide-binding protein and indicators of systemic inflammation in patients with moderate viral SARS-CoV-2 lung disease on the background of antibiotic therapy. Materials and methods . 60 patients hospitalized in the infectious diseases department with a positive PCR result for SARS-CoV-2 in the age group 44–70 years old were examined. The patients were divided into 2 groups: group 1 (n = 26) – patients who did not receive antibacterial drugs at the outpatient stage, group 2 (n = 34) – patients who received antibiotic therapy. The control group was also selected (n = 20). Patients underwent a study of the level of lipopolysaccharide-binding protein (LBP), ferritin and C-reactive protein in the peripheral blood. Results . In the group of patients with new coronavirus infection who were admitted to the inpatient stage of treatment and received antibacterial therapy at the outpatient stage, a significantly higher levels of LBP – 37.3 [13.8; 50.4] µg/ml (p˂0.05) and ferritin – 276.00 [184.00; 463.00] µg/ml (p˂0.05) were revealed, compared with group 1 and the control group. Conclusions . In the group of patients who received antibiotic therapy at the outpatient stage, a significantly higher level of LBP was revealed compared to the group in which this group of drugs was not used. These results indicate the possible impact of uncontrolled and early intake of antibacterial drugs on the gut microbiome and intestinal permeability, and also prove the need for a more responsible approach to the choice of starting therapy for new coronavirus infection.