Ali Ahmed S, ASattar Mai A, Karim Shahid, Kutbi Dina, Aljohani Hanin, Bakhshwin Duaa, Alsieni Mohammed, Alkreathy Huda M
Department of Pharmacology Faculty of Medicine, King Abdulaziz University, Saudi Arabia.
Department of Pharmaceutics Faculty of Pharmacy, Assiut University, Egypt.
Arab J Chem. 2021 Mar;14(3):102983. doi: 10.1016/j.arabjc.2020.102983. Epub 2021 Jan 10.
A novel corona virus SARS-CoV-2 has led to an outbreak of the highly infectious pandemic COVID-19 complicated viral pneumonia. Patients with risk factors frequently develop secondary infections where the role of appropriate antibiotics is mandatory. However, the efforts of drug repurposing lead to recognizing the role of certain antibiotics beyond the management of infection. The current review provided the detailed antiviral, immunomodulatory effect, unique pharmacokinetic profile of two antibiotics namely azithromycin (AZ) and doxycycline (DOX). It summarizes current clinical trials and concerns regarding safety issues of these drugs. Azithromycin (AZ) has amazing lung tissue access, wide range antibacterial efficacy, conceivable antiviral action against COVID-19. It also showed efficacy when combined with other antiviral drugs in limited clinical trials, but many clinicians raise concerns regarding cardiovascular risk in susceptible patients. DOX has a considerable role in the management of pneumonia, it has some advantages including cardiac safety, very good access to lung tissue, potential antiviral, and immunomodulation impact by several mechanisms. The pharmacological profiles of both drugs are heightening considering these medications for further studies in the management of COVID-19.
一种新型冠状病毒SARS-CoV-2导致了具有高度传染性的大流行疾病COVID-19并发病毒性肺炎的爆发。有风险因素的患者经常发生继发性感染,在此情况下使用适当的抗生素是必不可少的。然而,药物重新利用的努力使得人们认识到某些抗生素在感染管理之外的作用。本综述详细介绍了两种抗生素阿奇霉素(AZ)和多西环素(DOX)的抗病毒、免疫调节作用以及独特的药代动力学特征。它总结了当前的临床试验以及对这些药物安全性问题的关注。阿奇霉素(AZ)具有出色的肺组织通透性、广泛的抗菌功效、对COVID-19可能的抗病毒作用。在有限的临床试验中,它与其他抗病毒药物联合使用时也显示出疗效,但许多临床医生对易感患者的心血管风险表示担忧。多西环素(DOX)在肺炎管理中具有重要作用,它具有一些优势,包括心脏安全性、良好的肺组织通透性、潜在的抗病毒作用以及通过多种机制产生的免疫调节影响。考虑到这些药物在COVID-19管理中的进一步研究,这两种药物的药理学特征正在得到更多关注。