Abstract
Objectives: Diabetes mellitus is one of critical causes of mortality annually. As the corona virus (covid 19) spread epidemically and has many proposed treatment methods. Remdesivir is one of the approved drugs that has antiviral activity inhibiting covid 19 in vitro and in vivo. Moreover, Remdesivir should be accompanied by other complementary medications to reduce hospitalization time. Among these drugs was levofloxacin and cefepime. This study shows the clinical outcome of cefepime and compare it with levofloxacin when combined with remdesivir as adjuvant drug in diabetic patients diagnosed with covid 19. Materials and methods: A retrospective multicenter study on 75 diabetic patients confirmed with COVID-19 diagnosis. The patients divided in two groups first group of 40 patients received remdesivir with intravenous levofloxacin, the second group include 35 patients received remdesivir plus intravenous cefepime. Results: Preliminary and rapid remdesivir treatment has revealed a good result. Interestingly, Cefepime and levofloxacin enhance mean D-dimer level from 0.9 µg/L to (0.8 µg/L and 0.85 µg/L respectively), mean CRP level from 65 µmol/L to (45 µmol/L and 51 µmol/L respectively) and LDH mean level from 250 (U/L) to (170 U/L in cefepime) versus (200 U/L in levofloxacin). Noteworthy, there were multiple parameters worsened by levofloxacin like ferritin level that turned from 920 µg/L to 500 µg/L in Cefepime versus 1029 µg/L in levofloxacin group. About mean recovery time in days cefepime group discharged from hospital in average 12 days but levofloxacin group average recovery time was 19 days. P value (p < 0.05) was considered significant. Conclusion: There was various antibiotics used in COVID-19 worldwide, specifically with patients suffering fundamental comorbidities like obesity, hypertension, and diabetes mellitus. Cefepime overweigh levofloxacin. Levofloxacin should be reserved to severe cases.