Dear Dr. Zubair!

You spotted an important point. May I argue that COVID-19 is now in the stage of rapid diffusion around the world. One can conclude that there is a possibility in the future for significant mutations within the structure of this virus, and so there might emerge a need to integrate medicine, vaccine and plasma- with herbal therapies with innovative approach:

1) Anne Catherine Cunningh & Hui Poh Go & David Koh. (2020). "Treatment of COVID-19: old tricks for new challenges" Critical Care (2020) 24: @ Springer Nature Limited, Available at:

Article Treatment of COVID-19: Old tricks for new challenges

2) Shio-Shin Jean (2020). "Treatment options for COVID-19: The reality and challenges" Journal of Microbiology, Immunology and Infection, Vol. 53, Issue 3, June 2020, © 2020 Taiwan Society of Microbiology. Published by Elsevier Taiwan LLC., Available at: Article Treatment options for COVID-19: The reality and challenges

3) Harald Brussow (2020). "COVID‐19: From pathogenesis models to the first drug trials" @ 2020 The Authors. Microbial Biotechnology published by John Wiley & Sons Ltd and Society for Applied Microbiology, Open Access 23 June 2020, Available at:

Article COVID‐19: From pathogenesis models to the first drug trials

4) Dr. Michael J. Miller, Ulrich Herber and Lori Daane (2020). " Rapid Microbiology Applications in the COVID-19 Era" Microbiology Consulting LLC., Scheduled to take place August 4, 2020 on the BrightTALK-platform, further details:

https://www.brighttalk.com/webcast/10519/413804/rapid-microbiology-applications-in-the-covid-19-era

Register for free to the platform here: https://www.brighttalk.com/join/

Yours sincerely, Bulcsu Szekely

Antibiotic use in COVID-19 cases should be handled with caution and by clinicians with sound knowledge in the field mindful of the fact that some antibiotics suppress immunity thereby compounding the immunodeficiency state already in place.

The use of antibiotic in patients suffering fron ncovid- 19, probably it has no role as a treatment. It only imparts secondary role to prevent opportunistic infection in immunocompromized patients having ncovid19, where chances of infection is more. So, antibiotics are to be used judiciously by the physician by observing all facts and finding of his ncovid 19vpatients.

Antibiotics as such do not have any role to take care of covid19 cases. But there are many reports coming that there might be concurrent infection mostly by bacteria. In that situation, appropriate antibiotics hs an important role.

Dear Bulcsu Szekely , thank you very much for your thorough and insightful answer, I really get benefit from sits you mentioned.

Sincerely

Dear E. F. Chukwurah ,

Thank you for your reply, and I totally agree with you however there some specialty doctor that refuses to change their thoughts.

Dear Ajai Kr Pandey , thank you for your reply and I respect your idea, however, the rule of antibiotic could be a lot of benefits especially in some cases at early stages that may prevent secondary infection.

Dear Nirmal Mohakud , thank you for your reply, exactly that is the point.

As Covid-19 is a viral disease, antibiotics as such do not have any role; but many times there are chances of concurrent mixed infection of Covid-19 with other bacteria in that situation, appropriate antibiotics has an important role.

Dear Malangori Parande, thank you for your reply , yes perfect, as broad spectrum antibiotic rather than or with Azithromycin.

In severely ill patients arriving, present with pneumonia like picture or super imposed bacterial infection, it is hard to avoid antibiotic use. Regardless of how COVID-19 is impacting current antibiotic use, I would say the pandemic highlights the need to be prepared for the emergence of an infectious disease, whether it's viral or bacterial. In pediatric population, kids may present also with MIS-C picture (Kawasaki like picture) with fever for days lead also start empirical antibiotics until back, there is increase use for IVIG as well, as definition still cloudy for MIS-C cases with concern to not miss it and avoid morbidity and mortality

Thanks, Dear Muayad Alali, I appreciate your point of view, and indeed I agreed that the universe should be prepared well for this abnormal emergence of new resistance pathogen.

Azithromycin is effective in treatment of COVID-19.

https://www.thelancet.com/article/S0140-6736(20)31863-8/fulltext

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7290142/

Dear Arvind Singh thank you very much for your valuable contribution, its really interesting article and its true as I am now get Infected with Covid 19 and nice improvement on Azithromycin indeed.

they cover secondary bacterial infections associated with covid not the covid itself

In COVID-19 cases there is a low rate of bacterial co-infection. In a study among 1,705 patients, 3.5% were found to have a community-onset bacterial co-infection. https://www.cidrap.umn.edu/news-perspective/2020/08/studies-highlight-dynamic-impact-covid-19-antibiotic-use.

Without bacterial co-infection antibiotics of any type are of no use. It is wise not to prescribe an antibiotic without having any evidence of bacterial co-infection.

Dear @ Laith and Harasit , thank you for your valuable reply, of course antibiotic covers secodary bacterial infection not viral !, however, When you can truely judge that this attack of Covid is purely viral with no added bacterial?

Symptoms are vague and intermingled together, besides, early cover of emergance of secondary bacterial infection is of great benefit to alleviate the symptoms and especially Azithromycin with its new action

That could be true, make it adding it have no significant side effect.

Please, visit https://www.researchgate.net/deref/https%3A%2F%2Fwww.thelancet.com%2Farticle%2FS0140-6736(20)31863-8%2Ffulltext

Suggested by dear pArvind Singh,, its its really interesting.

After all, every one with his own believes.