Azithromycin for severe COVID-19.
Azithromycin for severe COVID-19.
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DOI：
10.1016/s0140-6736(20)31863-8
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发表时间：
2020-10-03
期刊：
影响因子：
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通讯作者：
Doan T
中科院分区：
文献类型：
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作者：
Oldenburg CE;Doan T
在随机对照试验之外，羟氯喹联合或不联合阿奇霉素被确定为治疗严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染的早期候选药物。随后启动了一些评估羟氯喹作为暴露前预防、早期治疗以及用于COVID-19住院患者的试验。到目前为止，随机试验没有发现任何证据表明羟氯喹在COVID-19的任何疾病阶段与安慰剂相比具有益处，并且由于招募困难和新出现的证据表明羟氯喹无效，许多试验提前终止。1-3尽管大量证据表明羟氯喹在治疗COVID-19方面没有益处，但很少有研究评估阿奇霉素，这是一种具有抗炎特性的广谱抗生素。阿奇霉素通常用于细菌性呼吸道感染，并可能治疗或预防与SARS-CoV-2的合并感染。阿奇霉素也可能对某些RNA病毒具有抗病毒活性。4，5阿奇霉素已被证明在体外有效对抗病毒，如寨卡病毒和鼻病毒，除了SARS-CoV-2，4，5，并在支气管上皮细胞中具有抗病毒作用。6阿奇霉素也被证明具有免疫调节作用，
Hydroxychloroquine with or without azithromycin was identified, outside of randomised controlled trials, as an early candidate for treatment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. A number of trials evaluating hydroxychloroquine as pre-exposure prophylaxis, as early treatment, and in patients admitted to hospital with COVID-19 were subsequently initiated. To date, randomised trials have found no evidence of a benefit of hydroxychloroquine compared with placebo at any disease stage for COVID-19, and a number of trials were discontinued early because of difficulties with enrolment and emerging evidence that hydroxychloroquine was not effective. 1–3Although the preponderance of evidence indicates that there is no benefit of hydroxychloroquine in the treatment of COVID-19, fewer studies have evaluated azithromycin, a broad-spectrum antibiotic that has anti-inflammatory properties. Azithromycin is commonly used for bacterial respiratory infections, and could potentially treat or prevent co-infection with SARS-CoV-2. Azithromycin might also have antiviral activity against some RNA viruses. 4, 5 Azithromycin has been shown to be effective in vitro against viruses such as Zika and rhinovirus, in addition to SARS-CoV-2, 4, 5 and to have antiviral effects in bronchial epithelial cells. 6 Azithromycin has also been shown to be immunomodulatory, 7 and can reduce