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Recent Developments in Therapies and Strategies Against COVID-19
Published in Hanadi Talal Ahmedah, Muhammad Riaz, Sagheer Ahmed, Marius Alexandru Moga, The Covid-19 Pandemic, 2023
Misbah Hameed, M. Zia-Ul-Haq, Marius Moga
Azithromycin is an antibiotic used against various bacterial infections. It belongs to the macrolide group of antibiotics. Azithromycin prevents bacterial growth by inhibiting the synthesis of protein. It binds to the 50S ribosomal subunit of the bacterial cell and inhibits the process of translation of mRNA. It is used in chest infections such as nose and throat infections, pneumonia, skin infection, and sexually transmitted infections. It has been suggested to be used in COVID-19 infection. It has been proven that Azithroymcin has good activity against Ebola and Zika viruses. Previously, has been part of adjunctive therapy to provide some immunomodulatory and anti-inflammatory results along with bacterial coverage of some respiratory tract infections like influenza. Currently, azithromycin has been tested in a number of trials along with HCQ as a treatment strategy in COVID-19 patients.
Antimicrobials during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Azithromycin is well absorbed orally and single-dose therapy is effective for chlamydial infections. This antibiotic was used as single-dose therapy for chlamydial infections during pregnancy without untoward outcomes (Allaire et al., 1995; Bush and Rosa, 1994; Rosenn et al., 1995; Turrentine et al., 1995). It is listed as an FDA category B drug by the manufacturer, and appeared not to cause birth defects (Box 2.4). In a study of 123 first-trimester exposures to azithromycin in the MOTHERISK program the frequency of birth defects was not increased (Sarkar et al., 2006). Among 914 first-trimester exposures to the drug, the frequency of congenital anomalies was not increased (Muanda et al., 2017). Among 914 infants exposed to azithromycin during the first trimester, the frequency of birth defects was not increased (Bérard et al., 2015). The frequency of newborn defects was not increased among 253 infants exposed to azithromycin during the first trimester in the Danish Registry (Andersen et al., 2013). In another study of 234 infants whose mother used azithromycin during the first trimester, the frequency of congenital heart defects was increased (Bar-Oz et al., 2012).
Conventional Pharmacological Strategies, Investigational Drugs, and Immunotherapies for COVID–19
Published in Srijan Goswami, Chiranjeeb Dey, COVID-19 and SARS-CoV-2, 2022
Subhra Bhattacharya, Srijan Goswami, Chiranjeeb Dey
The antibiotic azithromycin is conventionally used to treat respiratory infections caused by intracellular gram-positive bacteria. This antibiotic was used with other antiviral drugs for synergistic antiviral effects. Under FDA emergency use authorization, azithromycin in combination with hydroxychloroquine was being administered to COVID-19 patients as a primary treatment. This combination showed no significant effects, instead, it was found that the risks of cardiovascular failure and death were increased. Other adverse reactions included gastrointestinal disturbances and hepatotoxicity. The use of azithromycin in combination or standalone is not recommended for COVID-19 patients (Patel et al., 2021; Butler et al., 2021).
Development of taste-masking microcapsules containing azithromycin by fluid bed coating for powder for suspension and in vivo evaluation
Published in Journal of Microencapsulation, 2023
Pham-Thi-Phuong Dung, Thanh-Dat Trinh, Quoc-Hoai Nguyen, Huu-Manh Nguyen, Ngoc-Chien Nguyen, Ngoc-Bao Tran, Cao-Son Tran, Thi-Hong-Ngoc Nguyen, Nguyen-Thach Tung
Azithromycin (AZI) is a broad-spectrum macrolide antibiotic, commonly indicated for the treatment of different types of infections, including frequent childhood infections such as upper and lower respiratory tract infections, and otitis media. Azithromycin has a long half-life, allowing for a single dose or single daily dose regimen (Lo et al.2009) with the potential for increased compliance in children compared to frequent regimens of traditional antibiotics. However, AZI has an extremely bitter taste and it is unstable in gastric medium (Fiese and Steffen 1990). Side effects of AZI, such as nausea, vomiting, and diarrhoea, were demonstrated that related to the local concentration of drug in the GI tract (Lo et al.2009). Therefore, dosage forms containing AZI for paediatric patients, who are more bitter sensitive than adults (Mennella and Bobowski 2015) should fully mask the drug’s bitter taste and should be rapidly emptied from the stomach.
Neonatal ocular prophylaxis in the United States: is it still necessary?
Published in Expert Review of Anti-infective Therapy, 2023
Susannah Franco, Margaret R. Hammerschlag
Azithromycin and erythromycin are both lipophilic, meaning they readily penetrate across cellular membranes and into tissues (including the conjunctiva), resulting in a relatively high volume of distribution compared to hydrophilic drugs. While the lipophilicities of these two macrolides have not been compared, we can infer based on the volume of distribution (Vd) of azithromycin of 31.1 L/kg and the Vd of erythromycin of 0.64 L/kg that erythromycin is far less able to penetrate into body tissues. This is further illustrated by reports of the detection of azithromycin in body sites up to four weeks after a single oral dose [37]. While the Vd for both drugs are likely higher in infants due to their higher percentage of body fat, how their pharmacokinetic and pharmacodynamic data apply to ophthalmic formulations is unclear.
Comparative efficacy assessment of antiviral alone and antiviral-antibiotic combination in prevention of influenza-B infection associated complications
Published in Expert Review of Anti-infective Therapy, 2021
Azfar Ishaqui, Amer Hayat Khan, Syed Azhar Syed Sulaiman, Muhammad Taher Alsultan, Irfanullah Khan
Gram positive cocci pathogens emerge as the most common causative agents for secondary bacterial infections in Group-B1 patients. Streptococcus pneumoniae alone was responsible for one-fourth of the identified secondary bacterial infection. Pathogens from class atypical pneumonia (Mycoplasma pneumonia & Chlaymydia pneumoniae) were also found to be common with causative agent of 9 (28.1%) cases. In terms of sensitivity and susceptibility, azithromycin was found to be effective against atypical pneumonia agents as well as some Gram positive cocci. Azithromycin may modulate airway inflammation induced by influenza virus infection. Basic studies have shown that azithromycin is effective against secondary bacterial pneumonia after influenza virus infection because of its inhibitory effect on the expression of various cytokines and its antibacterial activity [51]. However, in our study the incidences of secondary bacterial infection were found in 5.1% of patients who were initiated on oseltamivir along with azithromycin. Ceftriaxone, cefepime and meropenam were found to be effective against pathogens from Gram positive cocci and Gram negative rods. Patients at high risk of complications or secondary infection should be considered for antibiotics in the presence of lower respiratory features. Patients should have antibiotics which are effective against Staphylococcus aureus and Streptococcus pneumoniae. Although all guidelines for the empirical treatment of community acquired pneumonia cover Streptococcus pneumoniae, Staphylococcus aureus poses more of a challenge.