Aminoglycosides have been reported to reduce viral load of BVDV, HCV, DENV 1-4, and SARS-CoV-2 in vitro [1,2] and HSV-2, ZIKV, and influenza A in mice [3]. Based on this, is there any ongoing clinical trial or local experience on the potential activity of eg. neomycin on SARS-CoV-2?
1. Article Antiviral activity of geneticin against dengue virus
2. Preprint Discovery of clinically approved drugs capable of inhibiting...
3. Article Topical application of aminoglycoside antibiotics enhances h...
A medical hypothesis on this was recently published: Article Aminoglycosides can be a better choice over Macrolides in CO...
No clinical trial involving aminoglycosides is being undertaken in our institute although its a very intriguing subject.
Downside of the aminoglycosides as antibiotics for COVID-19 patients
Aminoglycosides are less likely to be chosen for management of COVID-19 patients because these antibiotics need to be given as injections, and have plethora of side-effects particularly deafness and kidney injury unless the blood levels are monitored.
This will not make aminoglycosides are finding favour with doctors and patients as these drugs cannot be given except in admitted patients. With so many other choices of safer, easy to take oral antibiotics available, I am sure no doctor has seen it being given except in hospital-admitted COVID-19 patients with resistant organisms only sensitive to aminoglycosides.
I think no clinical evidence for aminoglycoside activity against SARS-CoV-2.
Thanks for the insights so far. Potential nephrotoxic and ototoxic side effects of aminoglycosides would certainly have be to be considered. There are however established topical alternatives at least for neomycin and tobramycin. Muhammad Yousuf are you aware of any epidemiological study of, say, patients undergoing treatment with nebulized tobramycin from which conclusions could be drawn as to their susceptibility to COVID-19?
Aminoglycosides as its can't be used in the clinical trials against COVID-19 until today, maybe more modifications are needed for more safety before making any plan to use it against COVID-19 in the human.
Not yet reported for clinical application. No evidence at present for routine use in clinical practice for COVID-19 infection.
But ahminoglycosides have antiviral activity mediated through defensins mechanism. Defensins can help in clearing virus from the respiratory tract and can block the viral activity by directly acting on the virus or on the target organs.
It may be considered an option in place of macrolides. Risk of aminoglycosides has to be kept in mind in this group of patients. Risk benefit ratio has to be considered.
Several reports now discuss a less-than-expected prevalence and severity of COVID-19 in people with cystic fibrosis. If this indeed is true, I wonder whether it could possibly be mediated by the regimen applied in managing the condition, potentially involving inhaled aminoglycosides. Alternatively, the observation could also be a mere effect of stricter precautions taken by people with cystic fibrosis.
Again, I am grateful for any constructive opinion on this.
Two interesting references:
https://doi.org/10.1016/j.jcf.2021.01.008
https://doi.org/10.1016/j.jcf.2020.10.003