Improved Outcomes with Trimethoprim or Cotrimoxazole in Patients with Severe COVID-19: A District Hospital Experience
6 Pages Posted: 26 Jun 2020 Last revised: 12 Jul 2021
Date Written: June 10, 2020
COVID-19 may become life-threatening as a result of the host mediated cytokine storm syndrome. There is no proven effective treatment available and the mainstay of management is supportive.
We retrospectively analysed data from 22 patients with severe COVID-19 treated with oral Trimethoprim (TMP) or Cotrimoxazole (CTX) in addition to standard therapy (ST) and compared these with 22 patients with severe COVID-19 who had received ST alone.
We observed that patients with severe COVID-19 receiving TMP/CTX in addition to ST had better outcomes. These include reduction in mortality (5% versus 32%, p=0.022), need for ventilatory support (3 versus 16 patients, p<0.001) and length of hospital stay (mean: 9 versus 22 days, p<0.001). Clinical parameters improved within 48 hours of starting treatment with TMP/CTX (SpO2/FiO2, p<0.001; C-Reactive Protein, p=0.002).
These results may be due to the antimicrobial and anti-inflammatory effects of TMP/CTX. Clinical trials with CTX in patients with severe COVID-19 are ongoing.
Note: Funding: None to declare
Declaration of Interest: None to declare
Keywords: Severe COVID-19, Trimethoprim, Cotrimoxazole, Antibiotic, Anti-inflammatory
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