Abstract: Article Evaluation of Antibacterial and Antiviral Drug Effectiveness in COVID-19 Therapy: A Data-Driven Retrospective Approach Rika Yulia 1 , Putri Ayu Irma Ikasanti 1 , Fauna Herawati 1,2, * , Ruddy Hartono 3 , Puri Safitri Hanum 4 , Lestiono 5 , Dewi Ramdani 6 , Abdul Kadir Jaelani 7 , Kevin Kantono 8 and Heru Wijono 4 1 2 3 4 5 6 7 8 *



 Citation: Yulia, R.; Ikasanti, P.A.I.; Herawati, F.; Hartono, R.; Hanum, P.S.; Lestiono; Ramdani, D.; Jaelani, A.K.; Kantono, K.; Wijono, H. Evaluation of Antibacterial and Antiviral Drug Effectiveness in COVID-19 Therapy: A Data-Driven Retrospective Approach. Pathophysiology 2022, 29, 92–105. https://doi.org/10.3390/ pathophysiology29010009 Academic Editor: Jonathan Steven Alexander Received: 9 December 2021 Accepted: 3 March 2022 Published: 7 March 2022 Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Department of Clinical and Community Pharmacy, Faculty of Pharmacy, Universitas Surabaya, Surabaya 60293, Indonesia; rika_y@staff.ubaya.ac.id (R.Y.); putriayuirma@gmail.com (P.A.I.I.) Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Indonesia, Depok 16424, Indonesia Department of Pharmacy, Rumah Sakit Bhayangkara, Surabaya 60231, Indonesia; rudd_apt@yahoo.com Faculty of Medicine, Universitas Surabaya, Surabaya 60293, Indonesia; purisafitrihanum@staff.ubaya.ac.id (P.S.H.); herwyno@staff.ubaya.ac.id (H.W.) Department of Pharmacy, Rumah Sakit Pusat TNI Angkatan Laut (RSPAL) Dr. Ramelan, Surabaya 60244, Indonesia; lestionoapt@gmail.com Department of Pharmacy, Rumah Sakit Umum Haji, Surabaya 60177, Indonesia; deramdani123@gmail.com Department of Pharmacy, RSUD Bangil, Pasuruan 67153, Indonesia; abusuquf@yahoo.co.id Department of Food Science, Auckland University of Technology, Private Bag 92006, Auckland 1142, New Zealand; kevin.kantono@aut.ac.nz Correspondence: fauna@staff.ubaya.ac.id Abstract: The clinical manifestations associated with COVID-19 disease is mainly due to a dysregulated host response related to the overexpression of inflammatory markers. Until recently, only remdesivir had gained FDA approval for COVID-19 hospitalized patients and there are currently no evidence-based therapeutic options or options for prevention of complications that have been established. Some medical treatments such as antivirals, antibacterials, antithrombotics, antipyretics, corticosteroids, interleukin inhibitors, monoclonal antibodies, convalescent plasma, immunostimulants, and vitamin supplements have been utilized. However, there are limited data to support their effectiveness. Hence, this study was attempted to identify and evaluate the effectiveness of antibacterials and antivirals used for COVID-19 using a retrospective cross-sectional approach based on the medical records of adult patients in four hospitals. The number of antibacterials was calculated in defined daily dose (DDD) per 100 bed-days unit. Both mixed-logit regression and analysis of covariance were used to determine the effectiveness of the aforementioned agents in relation to COVID-19 outcome and patients’ length of stay. The model was weighed accordingly and covariates (e.g., age) were considered in the model. Heart disease was found to be the most common pre-existing condition of COVID-19 hospitalized patients in this study. Azithromycin, an antibacterial in the Watch category list, was used extensively (33–65 DDD..