ABSTRACT
Background: Among the medications administered for the management of COVID-19 patients, the induction drugs used for intubation have received little attention. The aim of this study was to compare the effect of induction drugs on the mortality of patients with COVID-19 requiring intubation. Methods: In this retrospective study, all patients who were admitted to Shahid Sadoughi and Shahid Rahnemoun hospitals in Yazd from February to March 2020 with definitive diagnosis of COVID-19 and needed intubation were enrolled. Patients were divided into 4 groups based on the type of drugs used in intubation, and mortality rate was assessed at the end of the first, second, fourth, and seventh days of the study. Statistical analyses were performed using SPSS 20 and P values <.05 was considered significant. Results: In this study, 76 patients were examined. Patients were divided into 4 groups, of which 21 were in etomidate group, 8 in ketamine group, 21 in sodium thiopental group, and 35 in midazolam group. Mortality rate in these 4 groups was 25%, 12.5%, 14.3%, and 14.3% (p=0.822), respectively at the end of the first day after intubation; it was 83.3%, 12.5%, 28.6%, and 25.7% (p=0.001), respectively, at the end of the second day; it was 83.3%, 12.5%, 42.9%, and 42.9% (p=0.015), respectively, until the end of the fourth day; it was 100%, 25%, 61.9%, and 65.7% (p=0.007), respectively, until the end of the seventh day. Admission to intubation time interval was 0.91±0.99, 3.12±1.95, 4.09±2.44, and 4.74±2.62 days, respectively (p<0.001). Conclusion: The results of this study suggest that the use of etomidate may be associated with higher mortality in COVID-19 patients. Further studies are needed to verify the results of this study.
ABSTRACT
OBJECTIVE: The aim of this study was to investigate efficacy of azithromycin versus cephalexin for infection prophylaxisis in patients with simple traumatic wounds managed at emergency department. METHOD: This randomized controlled trial compared short-course therapy of once-daily azithromycin (500 mg before the wound repair followed by 250 mg/day for 5 days) with cephalexin (1000 mg before wound repair followed by 250 mg every 6 hours for 5 days) in the treatment of patients with simple traumatic wounds. A total of 366 patients were randomly selected for the study and 303 were evaluated for the final analysis. RESULTS: On completion of therapy, the rate of observed infection was 9.6% in the cephalexin group (15 patients, odds ratio=0.77, 95% confidence interval, 0.56 to 1.06) and 5.4% in the azithromycin group (8 patients, odds ratio 1.42, 95% confidence interval, 0.80 to 2.52). Both treatment indicated similar prophylactic efficacy during the study (P=0.197). CONCLUSION: Our study showed that Azithromycin as infection prophylaxis in simple traumatic wounds had the same effect as cephalexin but azithromycin is easier to use and more cost-effective compared to cephalexin.
