Pharmacological basis for the potential role of Azithromycin and Doxycycline in management of COVID-19

Ali, Ahmed; ASattar, Mai A.; Karim, Shahid; Kutbi, Dina; Aljohani, Hanin S.; Bakhshwin, Duaa; Alsieni, Mohammed; Alkreathy, Huda M.

doi:10.1016/j.arabjc.2020.102983

Cited by 14 publications

(10 citation statements)

References 93 publications

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“…Other than Case 2 , all other patients were treated with antibiotics such as Doxycycline, Azithromycin, or Ivermectin in monotherapy/combination. Anti-inflammatory and immunomodulatory properties of these medications ( Ali et al, 2021 , Echeverría-Esnal and Grau, 2021 ) may have affected the course of catatonia, but we have inadequate evidence in this study to comment upon the same, and further studies are required to clarify this relationship. All patients were asymptomatic for the COVID-19 related systemic manifestations.…”

Section: Discussionmentioning

confidence: 91%

Concurrent catatonia and COVID-19 infection – An experiential account of challenges and management of cases from a tertiary care psychiatric hospital in India

Sakhardande

Pathak

Jayant

et al. 2022

Asian Journal of Psychiatry

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Catatonia has been reported as one among many neuropsychiatric manifestations associated with COVID-19 infection. Catatonia and COVID-19 co-occurrence remain clinical concerns often posing challenges pertaining to diagnosis, and especially management. Limited information is available regarding the appropriate approaches to the management of catatonia in COVID-19 infection, particularly with reference to the safety and efficacy of benzodiazepines and Electro-convulsive therapy (ECT). We present our experience of five patients with catatonia consequent to heterogeneous underlying causes and concurrent COVID-19 infection, who received care at the psychiatric COVID unit of our tertiary care psychiatric hospital. An interesting observation included varying underlying causes for catatonia and the potential role that COVID-19 infection may have played in the manifestation of catatonia. In our experience, new-onset catatonia with or without pre-existing psychiatric illness and concurrent COVID-19 can be safely and effectively managed with lorazepam and/or ECTs. However, critical to the same is the need to implement modified protocols that integrate pre-emptive evaluation for COVID-19 disease and proactive monitoring of its relevant clinical parameters, thereby permitting judicious and timely implementation of catatonia-specific treatment options.

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Section: Discussionmentioning

confidence: 91%

Concurrent catatonia and COVID-19 infection – An experiential account of challenges and management of cases from a tertiary care psychiatric hospital in India

Sakhardande

Pathak

Jayant

et al. 2022

Asian Journal of Psychiatry

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“…From the known biological activities of the identified compounds in the non-polar fraction of the extract, we can speculate that the observed immunomodulatory properties are due to the azithromycin (84) and betulin (111), compounds that have been formerly stated to possess such properties [31][32][33]. Other compounds with biological activities that could affect the immunomodulation are autumnolide (6), phomoarcherin B (17), nahuoic acid A (29), 3-hydroxyechinenone (40), nootkatone (59), oligomycin C (78), plakevulin A (101), and anhydroretinol (112).…”

Section: Discussionmentioning

confidence: 99%

“…Our results revealed that P. papyraceum extract exhibits antibacterial activity against both Gram-negative and Gram-positive bacteria, with a more pronounced effect on the Gram-negative strains. Probably, this activity is due to the compounds diversonol (14), torularhodin (63), tanikolide (70), oligomycin C (78), and azithromycin (84), reported previously as antibacterial agents [31,32,[34][35][36][37][38]. Taking into account that many pathogenic bacteria develop resistance to the classical antibiotics, the cyanobacteria can be an alternative source of compounds with antibacterial activity.…”

Section: Discussionmentioning

confidence: 99%

A Novel Approach for Fast Screening of a Complex Cyanobacterial Extract for Immunomodulatory Properties and Antibacterial Activity

Teneva

Batsalova

Bardarov³

et al. 2022

Applied Sciences

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The filamentous cyanobacteria from genus Phormidium are rich natural sources of bioactive compounds that could be exploited as pharmaceuticals or nutraceuticals. In this study, we suggest a novel approach for assessing the immunomodulatory properties of the products derived from cyanobacteria. The influence of Phormidium papyraceum extract on the human leukocyte immunophenotype was evaluated by attempting to link this activity to certain putative compounds identified in the extract. By using three staining panels and flow cytometry, we found that the cyanobacterial extract affected mainly CD4+ T cells upregulating activated CD4+CD152+ T cells (15.75 ± 1.93% treated vs. 4.65 ± 1.41% control) and regulatory CD4+CD25+ T cells (5.36 ± 0.64% treated vs. 1.03 ± 0.08% control). Furthermore, P. papyraceum extract can modulate T cell subpopulations with a CD4+ effector/memory phenotype. Extract-treated cells showed increased production of IL-2 (55 ± 12 pg/mL) and IL-6 (493 ± 64 pg/mL) compared to the untreated, 21 ± 7 pg/mL and 250 ± 39 pg/mL, respectively. No significant changes were observed in the secretion of TNF-α. In addition, P. papyraceum extract displayed antibacterial activity against both Gram-negative (inhibition zone from 18.25 ± 0.50 mm to 20.28 ± 1.50 mm) and Gram-positive (inhibition zone from 10.86 ± 0.85 mm to 17.00 ± 0.82 mm) bacteria. The chemical profile of the cyanobacterial extract was determined using LC–ESI–MS/MS analysis, where at least 112 putative compounds were detected. Many of these compounds have proven different biological activities. We speculated that compounds such as betulin and the macrolide azithromycin (or their analogues) could be responsible for the immunomodulatory potential of the investigated extract. More studies are needed to determine and validate the biological activities of the determined putative compounds.

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“…10,11 Although there was no clinical evidence, AZM was listed in many countries as part of the COVID-19 treatment protocol. 12 This led to the public misinformation gained from social media that AZM can cure COVID-19. 13 During the second wave of the pandemic (September 2020 and until the study period of this work), Jordan got a very high rate of COVID-19 cases with a daily mortality rate of 2.6/100,000, reaching an overall of ~700,000 positive COVID-19 cases and ~10,000 deaths.…”

Section: Introductionmentioning

confidence: 99%

Azithromycin Misuse During the COVID-19 Pandemic: A Cross-Sectional Study from Jordan

Abdelmalek¹,

Mousa²

2022

IDR

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Since coronavirus disease 2019 (COVID-19) became a global pandemic, repurposing known drugs was the quickest way to combat the disease. The initial screening revealed that azithromycin (AZM) might have potential against COVID-19. Although clinical trials did not prove such efficacy, many countries have put AZM within their guidelines for treating COVID-19. Therefore, the present study was designed to assess the misuse of AZM in Jordan during the COVID-19 pandemic. Methods and Results: A cross-sectional study was conducted among community pharmacies in Jordan from March 27 to May 8, 2021, and 184 pharmacies data were collected from the Google forms. During COVID-19, 42.9% of pharmacies sold more than 20 packs of prescribed AZM per month compared to 46.7% of pharmacies used to sell 0-5 packs AZM prescriptions per month before the pandemic. During COVID-19, pharmacists significantly dispensed AZM with and without prescriptions 107% and 127%, respectively, more than before the pandemic (p < 0.0001). Overall, pharmacists stocked 121% more AZM packs during COVID-19 than before the pandemic (p < 0.0001). Additionally, most pharmacists (59.7%) believed that AZM could cure COVID-19 patients. However, using multinomial logistic regression analysis, low-experienced pharmacists were unsure if AZM could positively affect COVID-19 patients (p < 0.05, OR = 3.76, 95% CI = 1.23-11.52). Furthermore, low-experienced pharmacists believed that increased use of AZM for the treatment of viral infections could lead to negative consequences (p < 0.001, OR = 0.161, 95% CI 0.063-0.414). Conclusion:This study demonstrated that AZM is misused by physicians, pharmacists, and the public in Jordan. Since AZM efficacy on SARS-CoV-2 is scarce, there is a need for new guidelines by governmental health authorities to implement strict enforcement of AZM dispensing during COVID-19 to avoid negative consequences of bacterial resistance.

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Pharmacological basis for the potential role of Azithromycin and Doxycycline in management of COVID-19

Cited by 14 publications

References 93 publications

Concurrent catatonia and COVID-19 infection – An experiential account of challenges and management of cases from a tertiary care psychiatric hospital in India

Concurrent catatonia and COVID-19 infection – An experiential account of challenges and management of cases from a tertiary care psychiatric hospital in India

A Novel Approach for Fast Screening of a Complex Cyanobacterial Extract for Immunomodulatory Properties and Antibacterial Activity

Azithromycin Misuse During the COVID-19 Pandemic: A Cross-Sectional Study from Jordan

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