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COVID-19) Pandemic on National Antimicrobial Consumption in Jordan
antibiotics Article An Assessment of the Impact of Coronavirus Disease (COVID-19) Pandemic on National Antimicrobial Consumption in Jordan Sayer Al-Azzam 1, Nizar Mahmoud Mhaidat 1, Hayaa A. Banat 2, Mohammad Alfaour 2, Dana Samih Ahmad 2, Arno Muller 3, Adi Al-Nuseirat 4 , Elizabeth A. Lattyak 5, Barbara R. Conway 6,7 and Mamoon A. Aldeyab 6,* 1 Clinical Pharmacy Department, Jordan University of Science and Technology, Irbid 22110, Jordan; [email protected] (S.A.-A.); [email protected] (N.M.M.) 2 Jordan Food and Drug Administration (JFDA), Amman 11181, Jordan; [email protected] (H.A.B.); [email protected] (M.A.); [email protected] (D.S.A.) 3 Antimicrobial Resistance Division, World Health Organization, Avenue Appia 20, 1211 Geneva, Switzerland; [email protected] 4 World Health Organization Regional Office for the Eastern Mediterranean, Cairo 11371, Egypt; [email protected] 5 Scientific Computing Associates Corp., River Forest, IL 60305, USA; [email protected] 6 Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield HD1 3DH, UK; [email protected] 7 Institute of Skin Integrity and Infection Prevention, University of Huddersfield, Huddersfield HD1 3DH, UK * Correspondence: [email protected] Citation: Al-Azzam, S.; Mhaidat, N.M.; Banat, H.A.; Alfaour, M.; Abstract: Coronavirus disease 2019 (COVID-19) has overlapping clinical characteristics with bacterial Ahmad, D.S.; Muller, A.; Al-Nuseirat, respiratory tract infection, leading to the prescription of potentially unnecessary antibiotics. This A.; Lattyak, E.A.; Conway, B.R.; study aimed at measuring changes and patterns of national antimicrobial use for one year preceding Aldeyab, M.A. -
(MGH) COVID-19 Treatment Guidance
Version 8.0 4/28/2021 10:00AM © Copyright 2020 The General Hospital Corporation. All Rights Reserved. Massachusetts General Hospital (MGH) COVID-19 Treatment Guidance This document was prepared (in March, 2020-April, 2021) by and for MGH medical professionals (a.k.a. clinicians, care givers) and is being made available publicly for informational purposes only, in the context of a public health emergency related to COVID-19 (a.k.a. the coronavirus) and in connection with the state of emergency declared by the Governor of the Commonwealth of Massachusetts and the President of the United States. It is neither an attempt to substitute for the practice of medicine nor as a substitute for the provision of any medical professional services. Furthermore, the content is not meant to be complete, exhaustive, or a substitute for medical professional advice, diagnosis, or treatment. The information herein should be adapted to each specific patient based on the treating medical professional’s independent professional judgment and consideration of the patient’s needs, the resources available at the location from where the medical professional services are being provided (e.g., healthcare institution, ambulatory clinic, physician’s office, etc.), and any other unique circumstances. This information should not be used to replace, substitute for, or overrule a qualified medical professional’s judgment. This website may contain third party materials and/or links to third party materials and third party websites for your information and convenience. Partners is not responsible for the availability, accuracy, or content of any of those third party materials or websites nor does it endorse them. -
Anti-Inflammatory Effects of Amantadine and Memantine
Journal of Personalized Medicine Communication Anti-Inflammatory Effects of Amantadine and Memantine: Possible Therapeutics for the Treatment of Covid-19? Félix Javier Jiménez-Jiménez 1,* , Hortensia Alonso-Navarro 1 , Elena García-Martín 2 and José A. G. Agúndez 2 1 Section of Neurology, Hospital Universitario del Sureste, Arganda del Rey, E-28500 Madrid, Spain; [email protected] 2 University Institute of Molecular Pathology Biomarkers, UNEx. ARADyAL Instituto de Salud Carlos III, E-10071 Cáceres, Spain; [email protected] (E.G.-M.); [email protected] (J.A.G.A.) * Correspondence: [email protected]; Tel.: +34-636968395 Received: 2 October 2020; Accepted: 6 November 2020; Published: 9 November 2020 Abstract: We have reviewed current data on the anti-inflammatory effects of amantadine and memantine in clinical and in vivo models of inflammation, and we propose that these effects have potential interest for the treatment of the SARS-CoV-2 infection (COVID-19 disease). To that end, we performed a literature search using the PubMed Database from 1966 up to October 31 2020, crossing the terms “amantadine” and “memantine” with “inflammation” and “anti-inflammatory”. Amantadine and/or memantine have shown anti-inflammatory effects in chronic hepatitis C, in neuroinflammation induced by sepsis and by lipopolysaccharides, experimental models of multiple sclerosis, spinal cord injury, and respiratory diseases. Since the inflammatory response is one of the main pathogenetic mechanisms in the progression of the SARS-CoV-2 infection, anti-inflammatory effects of amantadine and memantine could be hypothetically useful in the treatment of this condition. This potential utility deserves further research. Keywords: amantadine; memantine; anti-inflammatory effects; SARS-Cov-2; COVID-19; therapy 1. -
Remdesivir Targets a Structurally Analogous Region of the Ebola Virus and SARS-Cov-2 Polymerases
Remdesivir targets a structurally analogous region of the Ebola virus and SARS-CoV-2 polymerases Michael K. Loa,1, César G. Albariñoa, Jason K. Perryb, Silvia Changb, Egor P. Tchesnokovc,d, Lisa Guerreroa, Ayan Chakrabartia, Punya Shrivastava-Ranjana, Payel Chatterjeea, Laura K. McMullana, Ross Martinb, Robert Jordanb,2, Matthias Göttec,d, Joel M. Montgomerya, Stuart T. Nichola, Mike Flinta, Danielle Porterb, and Christina F. Spiropouloua,1 aViral Special Pathogens Branch, US Centers for Disease Control and Prevention, Atlanta, GA 30329; bGilead Sciences Inc., Foster City, CA 94404; cDepartment of Medical Microbiology and Immunology, University of Alberta, Edmonton, AB T6G 2E1, Canada; and dLi Ka Shing Institute of Virology, University of Alberta, Edmonton, AB T6G 2E1, Canada Edited by Peter Palese, Icahn School of Medicine at Mount Sinai, New York, NY, and approved September 7, 2020 (received for review June 14, 2020) Remdesivir is a broad-spectrum antiviral nucleotide prodrug that remdesivir-selected EBOV lineages; this mutation resulted in a has been clinically evaluated in Ebola virus patients and recently nonconservative amino acid substitution at residue 548 (F548S) in received emergency use authorization (EUA) for treatment of the fingers subdomain of the EBOV L RdRp. We examined this COVID-19. With approvals from the Federal Select Agent Program mutation in several contexts: a cell-based minigenome, a cell-free and the Centers for Disease Control and Prevention’s Institutional biochemical polymerase assay, as well as in a full-length infectious Biosecurity Board, we characterized the resistance profile of recombinant EBOV. In the context of the infectious virus, the F548S remdesivir by serially passaging Ebola virus under remdesivir se- substitution recapitulated the reduced susceptibility phenotype to lection; we generated lineages with low-level reduced susceptibil- remdesivir, and potentially showed a marginal decrease in viral fit- ity to remdesivir after 35 passages. -
TITLE PAGE COVID-19 Treatment
Preprints (www.preprints.org) | NOT PEER-REVIEWED | Posted: 26 March 2020 doi:10.20944/preprints202003.0378.v1 Peer-reviewed version available at International Journal of Antimicrobial Agents 2020; doi:10.1016/j.ijantimicag.2020.106080 TITLE PAGE COVID-19 Treatment: Close to a Cure? – A Rapid Review of Pharmacotherapies for the Novel Coronavirus 1. Yang Song, PharmD, BCPS Department of Pharmacy Services CHI Franciscan Health-St. Joseph Medical Center Tacoma, WA 98405 [email protected] 2. Min Zhang, PharmD, BCPS Department of Pharmacy Services Boston Medical Center Boston, MA 02118 3. Ling Yin, PharmD, PhD, BCPS, BCOP Department of Pharmacy Services AdventHealth Celebration Cancer Institute Celebration, FL 34747 4. Kunkun Wang, PharmD Department of Pharmacy Services Fairbanks Memorial Hospital Fairbanks, AK 99701 5. Yiyi Zhou, PharmD Department of Pharmacy Services Beijing United Family Hospital Beijing, China 100016 6. Mi Zhou, MM Department of Pharmacy Services Children’s Hospital of Soochow University Suzhou, China 215000 7. Yun Lu, PharmD, MS Associate Clinical Professor, University of Minnesota Department of Pharmacy Services Hennepin County Medical Center Minneapolis, MN 55415 1 © 2020 by the author(s). Distributed under a Creative Commons CC BY license. Preprints (www.preprints.org) | NOT PEER-REVIEWED | Posted: 26 March 2020 doi:10.20944/preprints202003.0378.v1 Peer-reviewed version available at International Journal of Antimicrobial Agents 2020; doi:10.1016/j.ijantimicag.2020.106080 Abstract Currently, there is no specific treatment for COVID-19 proven by clinical trials. WHO and CDC guidelines therefore endorse supportive care only. However, frontline clinicians have been applying several virus- based and host-based therapeutics in order to combat SARS-CoV-2. -
An Examination of COVID-19 Medications' Effectiveness
healthcare Review An Examination of COVID-19 Medications’ Effectiveness in Managing and Treating COVID-19 Patients: A Comparative Review Mahmoud Al-Masaeed 1,* , Mohammad Alghawanmeh 2, Ashraf Al-Singlawi 3 , Rawan Alsababha 4 and Muhammad Alqudah 1 1 Faculty of Health and Medicine, University of Newcastle, Callaghan 2308, Australia; [email protected] 2 Faculty of Pharmacy, Philadelphia University, Amman 19392, Jordan; [email protected] 3 Independent Scholar, Amman 11731, Jordan; [email protected] 4 School of nursing and Midwifery, Western Sydney University, Sydney 2560, Australia; [email protected] * Correspondence: [email protected] Abstract: Background: The review seeks to shed light on the administered and recommended COVID- 19 treatment medications through an evaluation of their efficacy. Methods: Data were collected from key databases, including Scopus, Medline, Google Scholar, and CINAHL. Other platforms included WHO and FDA publications. The review’s literature search was guided by the WHO Citation: Al-Masaeed, M.; solidarity clinical trials for COVID-19 scope and trial-assessment parameters. Results: The findings Alghawanmeh, M.; Al-Singlawi, A.; indicate that the use of antiretroviral drugs as an early treatment for COVID-19 patients has been Alsababha, R.; Alqudah, M. An useful. It has reduced hospital time, hastened the clinical cure period, delayed and reduced the Examination of COVID-19 need for mechanical and invasive ventilation, and reduced mortality rates. The use of vitamins, Medications’ Effectiveness in minerals, and supplements has been linked to increased immunity and thus offering the body a Managing and Treating COVID-19 fighting chance. Nevertheless, antibiotics do not correlate with improving patients’ wellbeing and Patients: A Comparative Review. -
Remdesivir CHKD Guideline 4-3.Pdf
Type of Policy: Hospital Wide POLICY TITLE: Version 1.9 REMDESIVIR Effective Date: 06/17/2020 Background: Veklury® (remdesivir) is an antiviral drug originally developed to treat Ebola. Remdesivir works by inhibiting RNA-dependent RNA polymerase. Remdesivir has been shown to inhibit COVID-19, MERS, and SARS in-vitro and in animal models. Research on the use of remdesivir in COVID-19 is on-going. As of 10/22/2020, remdesivir is the only FDA approved drug for the treatment of COVID-19 in patients ≥ 12 years of age weighing ≥ 40 kg. An updated Emergency Use Authorization (EUA) was approved on 10/22/2020 for suspected or laboratory-confirmed COVID-19 in hospitalized pediatric patients weighing 3.5 kg to less than 40 kg or hospitalized pediatric patients less than 12 years of age weighing at least 3.5 kg. Remdesivir may be utilized via 2 methods: 1) FDA approved use for the treatment of COVID-19 in patients ≥ 12 years of age AND > 40 kg 2) Emergency Use Authorization (EUA)-for hospitalized patients < 12 years weighing ≥ 3.5 kg or hospitalized pediatrics patients weighing ≥ 3.5 kg to < 40 kg 1. FDA approved Patients a. 12 years of age and ≥ 40 kg b. No EUA is required for these patients c. Follow the dosing, preparation, administration, and monitoring recommendations per this guideline and current US Prescribing Information available at www.gilead.com/scienceand- medicine/medicines 2. Emergency Use Authorization (EUA): https://www.fda.gov/media/137564/download A new EUA was issued by the FDA on 10/22/20 approving use in hospitalized pediatric patients < 12 years of age weighing ≥ 3.5 kg or pediatric patients weighing ≥ 3.5 kg to < 40 kg For information on the authorized use of remdesivir and mandatory EUA requirements please refer to the Fact Sheet for Healthcare Providers (HCPs) available at: www.gilead.com/remdesivir. -
Drug Synergy of Combinatory Treatment with Remdesivir and the Repurposed Drugs Fluoxetine and Itraconazole Effectively Impairs S
bioRxiv preprint doi: https://doi.org/10.1101/2020.10.16.342410; this version posted October 16, 2020. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. It is made available under aCC-BY-NC-ND 4.0 International license. 1 Drug synergy of combinatory treatment with remdesivir and the repurposed drugs fluoxetine 2 and itraconazole effectively impairs SARS-CoV-2 infection in vitro. 3 Sebastian Schloer1, Linda Brunotte2, Angeles Mecate-Zambrano2, Shuyu Zheng3, Jing 4 Tang3, Stephan Ludwig2, Ursula Rescher1* 5 1Institute of Medical Biochemistry, Center for Molecular Biology of Inflammation, and “Cells 6 in Motion” Interfaculty Centre, University of Muenster, Von-Esmarch-Str. 56, D-48149, 7 Muenster, Germany 8 2Institute of Molecular Virology, Center for Molecular Biology of Inflammation, and “Cells in 9 Motion” Interfaculty Centre, University of Muenster, Von-Esmarch-Str. 56, D-48149, 10 Muenster, Germany 11 3Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, 12 Haartmaninkatu 8, 00029, Helsinki, Finland 13 *Correspondence: Ursula Rescher, [email protected], Tel. +492518352118, Fax. 14 +492518356748 15 running title: Combinatory drug treatment targeting both virus and host-factors to inhibit 16 SARS-CoV-2 infection 17 ABSTRACT 18 The SARS-COV-2 pandemic and the global spread of coronavirus disease 2019 19 (COVID-19) urgently calls for efficient and safe antiviral treatment strategies. A 20 straightforward approach to speed up drug development at lower costs is drug repurposing. 21 Here we investigated the therapeutic potential of targeting the host- SARS-CoV-2 interface 22 via repurposing of clinically licensed drugs and evaluated their use in combinatory 23 treatments with virus- and host-directed drugs. -
Treatment of Viral Infections Including COVID-19
Treatment of Viral Infections including COVID-19 Dr. Sujith J Chandy MBBS., MD., PhD., FRCP(Edin) Director, ReAct Asia Pacific Professor, Clinical Pharmacology Christian Medical College, Vellore, India 1 What is a Virus? An infective agent (intracellular parasite) …… ….. consists of a nucleic acid molecule in a protein coat / capsid …..able to multiply only within the living cells of a host 2 Types of Virus DNA VIRUS RNA VIRUS Rhabdo virus Pox virus Rubella virus Herpes virus Picorna virus Adeno virus Orthomyxo virus Hepadna virus Paramyxo virus Papilloma virus Retro virus Corona virus Most DNA viruses assemble in the nucleus; most RNA viruses in cytoplasm 3 The more ‘in’famous viruses in the last decade 4 Stages of viral replication & Targets for treatment Cell Entry Uncoating Translation of viral proteins Posttranslational modification Release 5 Mechanisms of anti-viral action • Inhibition of viral enzymes -viral DNA and RNA polymerase • Viral protein glycosylation, virus assembly, new virus particle transport, and virus release. • Other mechanisms -inhibition of ACE2 cellular receptor. • Acidification at the surface of the cell membrane inhibiting fusion of the virus, and immunomodulation of cytokine release 6 Problems with antiviral therapy • Drugs interfere with host cell metabolism: – this can lead to adverse effects • Adequate concentrations of drug need to be accumulated inside cell: - for good effect • Peak viral replication associated with symptoms: – therapy must be started earlier to be effective 8 Acyclovir • Guanosine derivative • Mechanism: 1. Inhibits herpes virus DNA polymerase 2. Incorporated into viral DNA – stops DNA strand elongation • PK – widely distributed, enters CSF & cornea • Preparations – tablet, vial, cream, eye ointment • ADR – burning sensation (topical), rashes (IV) Acyclovir - Uses • Genital Herpes Simplex • Mucocutaneous HSV • HSV encephalitis – IV therapy • HSV keratitis – eye ointment • Herpes Zoster – IV or oral. -
Treatment Available Antivirals
HOSPITAL PHARMACY PROCEDURES FOR THE MANAGEMENT OF ANTIVIRAL TREATMENT IN THE NEW CORONAVIRUS SARS-CoV-2 DISEASE COVID-19 Recommendations of the Spanish Society of Hospital Pharmacy March 19, 2020 Given the current situation caused by SARS-CoV-2 coronavirus (COVID-19) infection, the hospital pharmacy is an essential link in the health system. In order to contribute in the best possible way to the management of antiviral treatment, the Spanish Society of Hospital Pharmacy gives the following recommendations. TREATMENT The protocol for the treatment of COVID-19 recommended by de Ministry of Health is available and constantly updated in: https://www.mscbs.gob.es/profesionales/saludPublica/ccayes/alertasActual/nCov-China/documentos.htm The specific antiviral treatment includes the following drugs (informed consent required): Lopinavir/ritonavir (oral) Yao TT, Qian JD, Zhu WY, Wang Y, Wang GQ. A systematic review of lopinavir therapy for SARS coronavirus and MERS coronavirus and MERS coronavirus-A possible reference for coronavirus disease-19 treatment option. J Med Virol. 2020 Feb 27. doi: 10.1002/jmv.25729. B. Cao, Y. Wang, D. Wen, et al. A Trial of Lopinavir–Ritonavir in Adults Hospitalized with Severe Covid-19. NEJM 2020; This article was published on March 18, 2020, at NEJM.org. DOI: 10.1056/NEJMoa2001282 Lopinavir/ritonavir (oral) + interferon beta-1B (subcutaneous) Lopinavir/ritonavir (oral) +interferon alfa- 2B (nebulized) Remdesivir (intravenous) AVAILABLE ANTIVIRALS LOPINAVIR/RITONAVIR: LOPINAVIR/RITONAVIR 200/50 mg film-coated tablets KALETRA 200/50 mg film-coated tablets KALETRA 80/20 mg oral solution 60 ml INTERFERON BETA-1B: BETAFERON 250 mcg/ml powder and solvent for solution for injection. -
Overview of Planned Or Ongoing Studies of Drugs for the Treatment of COVID-19
Version of 16.06.2020 Overview of planned or ongoing studies of drugs for the treatment of COVID-19 Table of contents Antiviral drugs ............................................................................................................................................................. 4 Remdesivir ......................................................................................................................................................... 4 Lopinavir + Ritonavir (Kaletra) ........................................................................................................................... 7 Favipiravir (Avigan) .......................................................................................................................................... 14 Darunavir + cobicistat or ritonavir ................................................................................................................... 18 Umifenovir (Arbidol) ........................................................................................................................................ 19 Other antiviral drugs ........................................................................................................................................ 20 Antineoplastic and immunomodulating agents ....................................................................................................... 24 Convalescent Plasma ........................................................................................................................................... -
Immunomodulators Under Evaluation for the Treatment of COVID-19
Immunomodulators Under Evaluation for the Treatment of COVID-19 Last Updated: August 4, 2021 Summary Recommendations See Therapeutic Management of Hospitalized Adults with COVID-19 for the COVID-19 Treatment Guidelines Panel’s (the Panel) recommendations on the use of the following immunomodulators for patients according to their disease severity: • Baricitinib with dexamethasone • Dexamethasone • Tocilizumab with dexamethasone Additional Recommendations There is insufficient evidence for the Panel to recommend either for or against the use of the following immunomodulators for the treatment of COVID-19: • Colchicine for nonhospitalized patients • Fluvoxamine • Granulocyte-macrophage colony-stimulating factor inhibitors for hospitalized patients • Inhaled budesonide • Interleukin (IL)-1 inhibitors (e.g., anakinra) • Interferon beta for the treatment of early (i.e., <7 days from symptom onset) mild to moderate COVID-19 • Sarilumab for patients who are within 24 hours of admission to the intensive care unit (ICU) and who require invasive mechanical ventilation, noninvasive ventilation, or high-flow oxygen (>0.4 FiO2/30 L/min of oxygen flow) The Panel recommends against the use of the following immunomodulators for the treatment of COVID-19, except in a clinical trial: • Baricitinib with tocilizumab (AIII) • Interferons (alfa or beta) for the treatment of severely or critically ill patients with COVID-19 (AIII) • Kinase inhibitors: • Bruton’s tyrosine kinase inhibitors (e.g., acalabrutinib, ibrutinib, zanubrutinib) (AIII) • Janus kinase inhibitors other than baricitinib (e.g., ruxolitinib, tofacitinib) (AIII) • Non-SARS-CoV-2-specific intravenous immunoglobulin (IVIG) (AIII). This recommendation should not preclude the use of IVIG when it is otherwise indicated for the treatment of complications that arise during the course of COVID-19.