短焦点：阿奇霉素治疗呼吸道病毒感染 COVID-19：有效还是无效？
A short focus, azithromycin in the treatment of respiratory viral infection COVID-19: efficacy or inefficacy?
机构信息
Pharmaceutical Department, Usl Umbria 1, A.Migliorati Street, 06,132, Perugia, Italy.
Pharmaceutical Department, Asl Napoli 3 Sud, Dell'amicizia Street 22, 80035, Naples, Nola, Italy.
出版信息
Immunol Res. 2022 Feb;70(1):129-133. doi: 10.1007/s12026-021-09244-x. Epub 2021 Nov 5.
Abstract
Azithromycin is a macrolide antibiotic. Recent evidence has demonstrated in vitro activity against a wide variety of respiratory tract viruses, including SARS-CoV-2 responsible for the current global pandemic COVID-19. A mechanism of action acting on different phases of the viral cycle is assumed. In addition to its in vitro antiviral properties, some evidence also suggests immunomodulatory and antifibrotic activity. These properties of azithromycin could be useful in the treatment of viral respiratory tract infections such as COVID-19. However, clinical data on the antiviral efficacy of azithromycin in the treatment of respiratory tract infections are inconsistent, both when used as monotherapy and in polypharmacological combination. In addition, cases of azithromycin-induced QT long and malignant arrhythmias are reported. In this short review, we attempt to determine the role of azithromycin in the treatment of viral respiratory tract infections such as COVID-19, therapeutic efficacy, or inefficacy?
摘要
阿奇霉素是一种大环内酯类抗生素。最近的证据表明，它具有针对多种呼吸道病毒的体外活性，包括导致当前全球大流行 COVID-19 的 SARS-CoV-2。假设其作用机制作用于病毒周期的不同阶段。除了体外抗病毒特性外，一些证据还表明具有免疫调节和抗纤维化活性。阿奇霉素的这些特性可能对治疗病毒性呼吸道感染（如 COVID-19）有用。然而，阿奇霉素在治疗呼吸道感染方面的抗病毒疗效的临床数据并不一致，无论是单独使用还是联合使用多种药物。此外，还报道了阿奇霉素引起 QT 间期延长和恶性心律失常的病例。在这篇简短的综述中，我们试图确定阿奇霉素在治疗 COVID-19 等病毒性呼吸道感染中的作用、疗效或无效性？
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本文引用的文献
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2
Pharmacological agents modifying the renin angiotensin and natriuretic peptide systems in COVID-19 patients.调节新冠病毒肺炎患者肾素-血管紧张素和利钠肽系统的药物制剂
Wien Klin Wochenschr. 2021 Sep;133(17-18):983-988. doi: 10.1007/s00508-021-01855-6. Epub 2021 Apr 20.
3
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Cardiovasc Toxicol. 2021 Jun;21(6):498-503. doi: 10.1007/s12012-021-09649-y. Epub 2021 Apr 9.
4
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