Recent Developments in Therapies and Strategies Against COVID-19
Hanadi Talal Ahmedah, Muhammad Riaz, Sagheer Ahmed, Marius Alexandru Moga in The Covid-19 Pandemic, 2023
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.
Azithromycin
M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson in Kucers’ The Use of Antibiotics, 2017
Gastrointestinal disorders are the most common side effects of azithromycin (Periti et al., 1993; Treadway et al., 2002), with diarrhea/loose stools (4–5% of patients), nausea (3%), and abdominal pain (2–3%) being the most frequently reported. With the 2 g extended release formulation, the reported rates are nausea 17%, diarrhea/loose stools 18–55%, vomiting 4%, and abdominal pain 36% (Chandra et al., 2007; Okayasu et al., 2011). The incidence of gastrointestinal reactions due to azithromycin is lower, compared to erythromycin (Periti et al., 1993). The mechanism for the gastrointestinal effects is macrolide-induced endogenous release of motilin, which stimulates motilin receptors and has a prokinetic effect on the gut (Catnach and Fairclough, 1992).
Acute Otitis Media
John C Watkinson, Raymond W Clarke, Christopher P Aldren, Doris-Eva Bamiou, Raymond W Clarke, Richard M Irving, Haytham Kubba, Shakeel R Saeed in Paediatrics, The Ear, Skull Base, 2018
The optimum length of a treatment course if commenced has also been addressed in a meta-analysis. Short (less than 7 days) and long (more than 7 days) courses were compared. Risk of treatment failure at 1 month was higher with short courses of antibiotics (absolute difference of 3%) although had no benefit in the longer term. This difference was not observed when using ceftriaxone or azithromycin. In addition, gastrointestinal side effects were reduced when using azithromycin or short-acting antibiotics.22 In the presence of a tympanic membrane perforation or ventilation tubes, AOM may be treated equally successfully with oral or topical antibiotics. The potential ototoxicity of topical aminoglycoside ear drops in these cases is well recognized and dose-dependent, therefore prolonged topical treatment should be avoided.
Recent progress in the repurposing of drugs/molecules for the management of COVID-19
Published in Expert Review of Anti-infective Therapy, 2021
Divakar Sharma, Adinarayana Kunamneni
Azithromycin is an antibiotic used against bacterial infections especially middle-ear, throat and respiratory-related diseases like pneumonia. Few other in-vitro studies revealed that azithromycin also showed the potential activity against Ebola and Zika viruses [22,23]. A randomized clinical trial showed that azithromycin prevented severe respiratory tract infections caused by viruses [24]. The exact mechanism of azithromycin mode of action against the various viral infections is still unknown. Teicoplanin is a glycopeptide used against Gram-positive bacterial infections (Staphylococcal) and shown efficacy against different viruses like Ebola, influenza, HCV, HIV, MERS-CoV and SARS-CoV [25,26]. A study exhibited in-vitro activity against SARS-CoV-2 and suggested that teicoplanin acts on the early step of the viral life cycle by inhibiting the low pH cleavage of the viral spike protein by cathepsin L [27–29].
Antibiotic susceptibility variations of Methicillin-resistant Staphylococcus aureus after gamma irradiation
Published in International Journal of Radiation Biology, 2020
Soroush Oskouee, Seyed Amir Hossein Feghhi, Neda Soleimani
It is appropriate to review antibiotics’ mechanism of actions (those that are used in this research) before proceeding further. Oxacillin is known to be from Beta-lactam antibiotics group, PBPs (penicillin binding proteins) are the primary targets of the β-lactam agents. It has been hypothesized that the β-lactam ring mimics the D-alanyl D-alanine portion of peptide chain that is normally bound by PBP. The PBPs interact with β-lactam ring and consequently are not available for the synthesis of new peptidoglycan (Džidic et al. 2008). Piperacillin is also a broad-spectrum β-lactam antibiotic of the ureidopenicillin class (Tan and File 1995). Azithromycin prevents bacteria from growing by interfering with their protein synthesis. It binds to the 50S subunit of the bacterial ribosome, hence inhibiting translation of mRNA while nucleic acid synthesis is not affected (Parnham et al. 2014). Polymyxin B Alters bacterial outer membrane permeability by binding to a negatively charged site in the lipopolysaccharide layer, which has an electrostatic attraction for the positively charged amino groups in the cyclic peptide portion (Schindler and Teuber 1975). Trimethoprim and Sulfamethoxazole inhibit successive steps in the folate synthesis pathway (Wormser et al. 1982). Rifampin specifically inhibits bacterial RNA polymerase, the enzyme responsible for DNA transcription, by forming a stable drug-enzyme complex (Wehrli 1983).
Pharmacokinetic interaction between shuanghuanglian and azithromycin injection: a nonlinear mixed-effects model analysis in rats
Published in Xenobiotica, 2019
Jingchen Tian, Shusen Sun, Zhigang Zhao, Xingang Li
Azithromycin belongs to the new macrolide family of azalides, and it is used to treat many different types of bacterial infections, such as respiratory infections, skin infections, ear infections, sexually transmitted diseases and others. The concentration of azithromycin in tissues can be over 50 times higher than in plasma due to ion trapping and its high lipid solubility. This may result in various azithromycin side effects, including skin rash, fever, swollen glands, flu-like symptoms, muscle aches, severe weakness, unusual bruising or yellowing of skin or eyes. Azithromycin’s half-life allows a large single dose to be administered yet maintains bacteriostatic levels in the infected tissue for several days (Kobuchi et al., 2016; Ramaiah et al., 2016; Salman et al., 2015; Vodstrcil et al., 2017). Therefore, adverse drug reaction may occur several weeks after azithromycin administration. An accidental intravenous overdose in an infant was reported to cause severe heart block, resulting in residual encephalopathy (Tilelli et al., 2006).
Related Knowledge Centers
- Antibiotic
- Pathogenic Bacteria
- Otitis Media
- Streptococcal Pharyngitis
- Pneumonia
- Travelers' Diarrhea
- Gastroenteritis
- Malaria
- Oral Administration
- Intravenous Therapy