Azithromycin in combination with Chloroquine hydrochloride was reported to reduce viral load in a 6 day study

I don't think this might be a symptom relief

Dear Prof Majeda ... If azithromycin not work, it will not harm, and it is okay to prescribe this antibacterial agent to the patient at least it will treat the secondary infection that may cause by opportunistic bacteria.

I think azithromycin is not used alone but in combination with another drug. Synergistically, perhaps, they both would do something good for the human population. In a heavily referenced study conducted in France, a small number of patients with COVID-19 received either hydroxychloroquine alone or hydroxychloroquine in combination with azithromycin. The authors reported that detectable concentrations of SARS-CoV-2 fell significantly faster in the study participants than coronavirus patients at other French hospitals who did not receive either drug. In six patients also given azithromycin, this promising effect appeared to be even amplified.  However, the Center for disease control noted that the small, non-randomized study "did not assess clinical benefit(s)" associated with the treatment. In other words, the study did not probe whether the treated patients were more likely to recover and survive their illness. Additionally, the agency advised that doctors should be cautious when giving either drug to patients with chronic disease, such as kidney failure, and especially those "who are receiving medications that might interact to cause arrhythmias."

Sir Maurice ... azithromycin with chloroquine.... that’s right... see attached link please... Article Lack of a pharmacokinetic interaction between azithromycin a...

I don't think that azithromycin or erythromycin would alone be able to prevent the coronavirus (COVID-19) infection.

Majida M. Meteab Alshammari azithromycin helps to reduce the symptoms only.

Azithromycin in combination with Chloroquine hydrochloride was reported to reduce viral load in a 6 day study

Combination of Azithromycin and hydroxychloroquine showed some good response after a 6 day trial.

See results attached.

According to our results azithromycin inhibits virus replication directly. Whether or not using it is a matter of physicians.

Look at: Article SHORT COMMUNICATION Drugs Repurposing for Coronavirus Treatm...

Hello I can contribute both from some bibliographical research and own expérience. Macrolides are known for having some antiviral properties, on viruses close to SarsCov2. More recently, a study, reposted by Prof. Raoult on his website, noted that azythromicine inhibits SarsCov2 replication through several actions, similarly to Hydroxychloroquine : it is a weak base with ribosome affinity, hence prevents the virus from hijacking ribosomes.

I myself am infected with SarsCov2. After a few days of mild throat pain, I woke up saturday with very typical covid symptômes including intense chest pain making breathing uncomfortable. I took Chlarythromicine that i always have for prophylaxy of bactéries secondary infections, a condition frequent for me. My symptômes dramatically improved in 2 to 3 hours (while for a bacterial infection it will take at least 10 hours to feel an real improvement). I was taking it 2×500mg/day and before taking each pill i had a symptômes increased, then relief 1-2 hours after the intake. I forgot one pill one night and ended up coughing and almost not able to swallow. I took the 500mg pill and felt relief in 2 hours.

Now i am taking it 4x250 mg/day and apart from a bit of fatigue and very mild throat - chest pain i am fine.

I think erythromycin must be effective for COVID-19. According to Dr. Galvez and Dr. Dayer, macrolides such as erythromycin and clarithromycin were selected as a SARS-CoV-2 protease inhibitor. Therefore, macrolides treatments are worth carrying out. When macrolides are taken orally, their bioavailabilities become 50%.

Therefore, the condition of the patient is severe, he should take intravenous erythromycin. Macrolides have not only anti-viral effects but also anti-inflammatory effects. These anti-inflammatory effects save the patients with COVID-19-induced acute respiratory distress syndrome (ARDS). Even if SARS-Cov-2 disappears in patient, ARDS continues, resulting in death. Macrolides combined with corticosteroid are effective for ARDS. Corticosteroid monotherapy cannnot save patients.

There is more and more evidence that macrolides inhibit SARS-CoV-2 protease, amid of other possible effects. The best SARS-Cov-2 protease inhibitor, according to our predictive models based on molecular topology, is BRECANAVIR.

https://www.researchgate.net/publication/340448998_Azithromycin_promising_medicine_for_COVID_19_in_early_stage_by_effecting_on_mTOR_and_immune_system

https://www.authorea.com/users/320215/articles/449849-macrolide-clarithromycin-task-force-for-the-treatment-and-prophylaxis-of-covid-19-as-a-single-agent?mode=edit&fbclid=IwAR2TpmnoH-R-zghr6wU9yjNWnqzZYRx2EEaEkWvcv4oQQzAwuH1iH0rW2ak

Eduardo Mansilla If these results would be encouraging, it could then be possible to propose to the governments of the world to quickly implement a “whole-earth-all-persons-treatment-prophylaxis strategy with Clarithromycin as a single agent, to reduce the mortality, and maybe eradicate the virus from our planet. This proposition would keep waiting for the development of vaccines, as they are not available at the moment and need to follow the course of the research phases, especially to completely ensure the safety of humanity.

https://osf.io/tv8hq

Elsy Rivas: Dr Thank you for allowing us to participate in this project here in Piura - Peru, we had the first case of COVID 19 on March 6, we are Intensivists obviously we do procedures, we intubated, etc. and our hospital became COVID Hospital, we started the Macrolide prophylaxis a group of first-line doctors on different dates ... now we are a group of approximately 20 doctors and graduates ... so far our tests are negative, so we continue to work in the same spirit of helping because we are few doctors over here ... thanks, thanks, thanks 💪💪💪

Azithromycin and erythromycin are able to prevent bacterial infections , however COVID-19 is a viral infection. Therefore, the drugs which are protease inhibitors or those containing purine nucleotide may be more useful against corona virus.

Yes, I believe that both macrolides could be used. Nevertheless, it seems Clarithromycin is better. See this paper "Short Communication- Drugs Repurposing for Coronavirus Treatment: Computational Study Based On Molecular Topology." by Jorge Galvez. Published March 2020.

Macrolides seem to inhibit not only SARS-CoV-2 protease but also RNA polimerase and the spike protein. Moreover, they may show antiimflammatory and inmunomodulatory effects. Some clinical trials have already began (https://www.youtube.com/watch?v=m34sPKeBo6A). However, probably it maybe necessary balance their use as antiviral baecause the possible appearance of bacterial resistances.

Erythromycin(EM) is an old drug that has already many EM resistant bacteria. According to Dr. Galvez article, EM is superior to azithromycin (AZM) regarding SARS-CoV-2 eradication. Therefore, EM should be used instead of AZM. For the purpose of preventing the appearance of EM resistant SARS-CoV-2, I propose the treatment with EM and ivermectin, a macrolide. Even if mild COVID-19 patients unfortunately result in acute respiratory distress syndrome, intravenous EM and cirticosteroide treatment will save them (Gazi Medical Journal 2019; 30:396-400.).

Yes. Dr. Ohe's thoughts are correct. Moreover, the key issue, according to many colleagues, seems to be an early treatment (see for instance: https://doi.org/10.1111/dth.13785); i.e. do not wait until the patient is at the hospital but provide the treatment just immediately the first symptoms. Anyway, it seems clear that sanitary authorities should consider macrolides as a serious alternative for Covid-19 patients.

Regarding infection-related acute respiratory distress syndrome, Dr. Kawamura's article was published. Anyway, macrolides are inevitable treatment for COVID-19.

Kawamura, K., Ichikado, K., Takaki, M. et al. Efficacy of azithromycin in sepsis-associated acute respiratory distress syndrome: a retrospective study and propensity score analysis. SpringerPlus 5, 1193 (2016). https://doi.org/10.1186/s40064-016-2866-1

Article Macrolide-Clarithromycin Task-Force for the Treatment and Pr...

¨ If Clarithromycin could have the desired anti SARS-CoV-2 effect, then, rescue prescribing strategies, initiated by the own patient at an early stage with this macrolide Clarithromycin, could aid effective delivery not only of an outstanding antimicrobial but also of an antiviral in the same tablet, significantly reducing hospital admissions, and lowering mortality.

While less antimicrobial resistance should remain a global priority, the current pandemic highlights the need for unprecedented management strategies. For example, in the current context, it may be entirely appropriate for nursing homes to have routine stockpiles of antibiotics [89], but as we have said, specifically clarithromycin. Rapid interventions like this could be life-saving, allowing rapid and appropriate prescribing decisions that could minimize morbidity and mortality of COVID-19, as well as reducing the impact of the pandemic on health services most exposed to this virus.

In this context, equipping patients and medical personnel in the first lines with rescue clarithromycin for Primary Prophylaxis as we have proposed for the first time, may be a legitimate strategy to consider in this pandemic, and should be tried in a Controlled Clinical Trial.

Although the patients should take erythromycin four times a day, they should take clarithromycin twice daily. At the same time, according to Dr. Galvez's article, clarithromycin is superior to erythromycin and azithromycin regarding SARS-CoV-2 eradication. Therefore, I look forward to the result of clarithromycin treatment.

Yes, I agree clarithromycin should be the best choice.

We have in Argentina the long acting formulation ( once a day-500 mg UD- una x dia-once per day-oral intake ) that is very well tolarated and works really fine.

https://www.facebook.com/30664024188/posts/10158848959999189/?app=fbl

In a few months, we will have this response with our Clinical Trial, based on this paper cited by Mansilla et.al (2020).