4 ms·

Are any large(r) scale trials incorporating Azithromycin as well? The "most promising" study I saw early on was this one: https://www.ncbi.nlm.nih.gov/pmc/arti

Are any large(r) scale trials incorporating Azithromycin as well? The "most promising" study I saw early on was this one: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7102549/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7102549/ - which seemed to suggest that the combo eliminated the viral load in 3-5 days. The only followup study I've found was this one: https://www.medrxiv.org/content/10.1101/2020.04.08.20054551v1 https://www.medrxiv.org/content/10.1101/2020.04.08.20054551v... - that urged caution with the combo because of a possibility of increased heart failure. Obviously, that's a very small study with

giardini 7y ago
Other antibiotics than azithromycin have been used, e.g., doxycycline. The antibiotic's purpose is to halt opportunistic bacterial infection; many antibiotics are available to do that.
- robbiep 7y ago
  But azithromycin has an ACE2 inhibitory effect and its use in disease modulation is postulated to decrease viral entry to the cell in a similar mechanism to HCQ, hence the discussion of dual therapy there. The opportunistic bacterial infection is separate (although you’re correct that it has a role here)
Reelin 7y ago
The preprint you linked (https://www.medrxiv.org/content/10.1101/2020.04.08.20054551v1 https://www.medrxiv.org/content/10.1101/2020.04.08.20054551v...) is a huge analysis based on historical health records (> 300k per condition). > Worryingly, significant risks are identified for combination users of HCQ+AZM even in the short-term as proposed for COVID19 management, with a 15-20% increased risk of angina/chest pain and heart failure, and a two-fold risk of cardiovascular mortality in the first month of treatment. Based on that, azithromycin would appear to be a decidedly bad choice of antibiotic to use in conjunction with HCQ. Luckily there are many others available. Derek Lowe has a recent and much more detailed analysis of all of this. (https://blogs.sciencemag.org/pipeline/archives/2020/04/11/the-latest-hydroxychloroquine-data-as-of-april-11 https://blogs.sciencemag.org/pipeline/archives/2020/04/11/th...)

giardini 7y ago

Other antibiotics than azithromycin have been used, e.g., doxycycline. The antibiotic's purpose is to halt opportunistic bacterial infection; many antibiotics are available to do that.

robbiep 7y ago
But azithromycin has an ACE2 inhibitory effect and its use in disease modulation is postulated to decrease viral entry to the cell in a similar mechanism to HCQ, hence the discussion of dual therapy there. The opportunistic bacterial infection is separate (although you’re correct that it has a role here)

Reelin 7y ago

The preprint you linked (https://www.medrxiv.org/content/10.1101/2020.04.08.20054551v1 https://www.medrxiv.org/content/10.1101/2020.04.08.20054551v...) is a huge analysis based on historical health records (> 300k per condition). > Worryingly, significant risks are identified for combination users of HCQ+AZM even in the short-term as proposed for COVID19 management, with a 15-20% increased risk of angina/chest pain and heart failure, and a two-fold risk of cardiovascular mortality in the first month of treatment. Based on that, azithromycin would appear to be a decidedly bad choice of antibiotic to use in conjunction with HCQ. Luckily there are many others available. Derek Lowe has a recent and much more detailed analysis of all of this. (https://blogs.sciencemag.org/pipeline/archives/2020/04/11/the-latest-hydroxychloroquine-data-as-of-april-11 https://blogs.sciencemag.org/pipeline/archives/2020/04/11/th...)