Discover and read the best of Twitter Threads about #azithromycin
Most recents (24)
THIS
👇👇👇
Fauci knew that death from respiratory viruses essentially does not happen in the absence of bacterial pneumonia.
[KNOWINGLY] Withdrawing #azithromycin and other drugs from #COVID protocols caused the deaths.
#FauciKnew
👇👇👇
Fauci knew that death from respiratory viruses essentially does not happen in the absence of bacterial pneumonia.
[KNOWINGLY] Withdrawing #azithromycin and other drugs from #COVID protocols caused the deaths.
#FauciKnew
#FauciKnew knew about the secondary pneumonias and he knew that the difference in the later outbreaks was the antibiotics.
It was his paper.
It was his paper.
This is what we are talking about. JJ Couey is asking you to stop being distracted by a virus. Yes it's important but...
It was an #iatrocide.
It didn't need to happen.
It was an #iatrocide.
It didn't need to happen.
Our #RCT of #azithromycin vs placebo for outpatient #COVID is out today in @JAMA_current
Tl;dr – azithromycin doesn’t help improve symptoms in outpatients with COVID and might make things worse, so don’t use it. 1/n
jamanetwork.com/journals/jama/…
Tl;dr – azithromycin doesn’t help improve symptoms in outpatients with COVID and might make things worse, so don’t use it. 1/n
jamanetwork.com/journals/jama/…
Why did we do this study? Azithromycin was identified early on as a potential candidate for COVID (+/- HCQ). Although it’s relatively safe, antibiotic use causes antibiotic resistance, and unnecessary widespread use of an antibiotic is a bad call. We need to know if it works. 2/n
There were some reasons to think it MIGHT work: azithromycin has anti-inflammatory properties and is used in other pulmonary diseases to reduce inflammation and has some in vitro anti-viral properties. But that doesn’t necessarily translate to efficacy, so we need a trial. 3/n
#Azithromycin associated w/ #COVID_19 associated pulmonary #aspergillosis. OR 3.1 (1.1-8.5). Just published in @CMIJournal (bit.ly/2JN1fDS). Could it be a risk factor ? More on this hypothesis ⬇️ 1/5
#Azithromycin >1500mg in humans = inhibition of oxydative burst in #neutrophils up to 28 days after last dose. By Culic et al. (bit.ly/3mPkYkd) 2/5
#Neutrophils = first barrier against fungal infection. Oxydative burst necessary for NETs formation. Genetic defect in oxydative burst leads to CGD with well-known increased susceptibility to #aspergillosis (bit.ly/2VJu1aN). 3/5
The story of #hydroxychloriquine .. we are all familiar, those who had been tracking #COVID19 from Feb 2020.. till now..
BUT I'm going telling to you, there's another side to this story, which ultimately shows #HydroxycholoroquineWorks !! cc @raoult_didier
tabletmag.com/sections/scien…
BUT I'm going telling to you, there's another side to this story, which ultimately shows #HydroxycholoroquineWorks !! cc @raoult_didier
tabletmag.com/sections/scien…
It all started from Raoult's study as detailed below.. 3 groups;
Group 1: 14 Px given HCQ or #hydroxychloriquine ,
Group 2: 6 Px given HCQ + #azithromycin
Group 3: "control group" of 16 from other hospital; no new Rx or refused.. 1/n
tabletmag.com/sections/scien…
Group 1: 14 Px given HCQ or #hydroxychloriquine ,
Group 2: 6 Px given HCQ + #azithromycin
Group 3: "control group" of 16 from other hospital; no new Rx or refused.. 1/n
tabletmag.com/sections/scien…
Then rationale of not having usual RCT (Random Controlled Test) .. coz to Raoult, it's morally NOT right to withhold a possible effectice treatment to deadly disease.. Remember, all this would be in Mac/Apr of 2020 in Europe.. hotbed of #COVID19 .. 2/n
tabletmag.com/sections/scien…
tabletmag.com/sections/scien…
🔥With @DgCostagliola we have published a response to the article by Risch in @AmJEpi on the outpatient treatment of #COVIDー19
There was and is no convincing evidence that #HCQ + #Azithromycin prevent hospitalisation in high-risk #COVID19 outpatients👇
academic.oup.com/aje/article/do…
There was and is no convincing evidence that #HCQ + #Azithromycin prevent hospitalisation in high-risk #COVID19 outpatients👇
academic.oup.com/aje/article/do…
In Gautret 1, that should be retracted by #IJAA, 6 patients were excluded w/o justification among the 26 treated with #HCQ. The appropriate test should compare the 14 patients who received #HCQ alone to the 6 who received the combination, and this test is not significant (p=0.39)
Risch stated that the only valid criticism against this trial is the lack of randomization. He rejects the criticism about the "small study size", saying that size matters only when no evidence is found. But no evidence is found in this study as shown above...
“Using molecular dynamic simulations, this study shows that #hydroxychloroquine and #azithromycin act in synergy to prevent any close contact between #SARSCoV2 virus and the plasma membrane of host cells.”
#COVID19Canada #medtwitter
sciencedirect.com/science/articl…
#COVID19Canada #medtwitter
sciencedirect.com/science/articl…
2/ “Molecular mimicry btwn #azithromycin & ganglioside sugar is revealed. Azithromycin binds to the virus spike protein of #SARSCoV2 and #hydroxychloroquine binds to gangliosides. ATM is directed against the virus, whereas HCQ is directed against cellular attachment cofactors.”
3/ “This is consistent w/synergistic antiviral mechanism at plasma membrane level, where therapeutic intervention is likely to be most efficient. This molecular mechanism may explain beneficial effects of #hydroxychloroquine & #azithromycin combination therapy in pts w/ #COVID19”
An evaluation of mass #azithromycin distribution on respiratory #virome suggests children have ⬇️non-SARS coronavirus viral load in communities receiving azithromycin compared to placebo. These findings are intriguing, with some important considerations.
academic.oup.com/cid/advance-ar…
academic.oup.com/cid/advance-ar…
This is a non-prespecified analysis from the #MORDOR study. These data pre-date COVID19 emergence by years. Most importantly, this paper does not say anything about whether azithromycin does or does not work for COVID19.
Mechanism unclear (and this study is not designed to address that). Azithromycin has anti-inflammatory effects, so could be related to that. Could be some secondary effect of reducing bacterial effect, or an off-target effect on viral replication. Also could be chance.
Like many, I’ve had some extra fee time these days... After rebinging @theofficenbc and #theofficereunion I was inspired.
A thread of Trump’s handling of the #coronavirus (#COVID19) pandemic, as told by Michael Scott. #TheOffice
A thread of Trump’s handling of the #coronavirus (#COVID19) pandemic, as told by Michael Scott. #TheOffice
Way back in 2018, Trump decided it was a good idea to disassemble the #Pandemic Response Team – created by the Obama administration in case there was “an airborne disease that is deadly.” This can’t go wrong! #thiswaspreventable
Trump does nothing to replace this. He plays golf and insults people on Twitter – just the normal things that presidents do right?
21/ #ZelenkoProtocol
1. Abstract Conclusion = Zinc helps
2. But: Paragraph 2 under METHODS
3. Essential to read study's methods
"Patients were *included* if ... had either been discharged from the hospital, transitioned to hospice or expired"
Full PDF:
drive.google.com/file/d/1XkIHqV…
1. Abstract Conclusion = Zinc helps
2. But: Paragraph 2 under METHODS
3. Essential to read study's methods
"Patients were *included* if ... had either been discharged from the hospital, transitioned to hospice or expired"
Full PDF:
drive.google.com/file/d/1XkIHqV…
22/ #Hydroxychloroquine & #Chloroquine & #Azithromycin
Norwegian Medicines Agency published a Warning April 23 & updated it on May 6.
Translates perfectly to English:
bit.ly/3fBSN5b
Citations:
medrxiv.org/content/10.110…
medrxiv.org/content/10.110…
#TrumpLiesAmericansDie
Norwegian Medicines Agency published a Warning April 23 & updated it on May 6.
Translates perfectly to English:
bit.ly/3fBSN5b
Citations:
medrxiv.org/content/10.110…
medrxiv.org/content/10.110…
#TrumpLiesAmericansDie
23/ #Remdesivir & #Vaccines & #SARSCoV2 & #COVID19
Norwegian Medicines Agency reports:
"Investigations started in Europe"
EMA - Remdesivir:
ema.europa.eu/en/news/ema-st…
NMA - Medicines & Vaccines:
legemiddelverket.no/english/covid-…
#TrumpPressConf #TrumpLiesAmericansDie
Norwegian Medicines Agency reports:
"Investigations started in Europe"
EMA - Remdesivir:
ema.europa.eu/en/news/ema-st…
NMA - Medicines & Vaccines:
legemiddelverket.no/english/covid-…
#TrumpPressConf #TrumpLiesAmericansDie
Let’s talk about the zinc. This supplement has gone viral together with #hydroxychloroquine and #azithromycin hype, and has been promoted without scientific evidence.
thread🔻
thread🔻
Most Zinc supporter refer to this article published on PLoS Pathogen in 2010, which described an in vitro inhibitory effect of Zn against SARS-CoV. Author also suggests the RdRp-dependent potential mechanism. Can this be translated to SARS-CoV-2? Let’s dive in.
The sequence & structural homology of RdRp between SARS-CoV and SARS-CoV-2 is high. Both have structured Zn ion, which looks like a cofactor critical for its activity. But the pharmacological perturbation with excessive Zn ion is largely unknown. science.sciencemag.org/content/early/…
NYU Med school study of ~ 900 #Covid_19 patients. Patients receiving #Hydroxychloroquine, #azithromycin and zinc sulfate had a 1.5 times greater chance of recovering & were 44 percent less risk to die, compared to those without zinc. news.yahoo.com/zinc-hydroxych…
Administration of the HCQ+AZ combination BEFORE #Covid_19 complications occur is safe and associated with a very low FATALITY rate in patients. Interesting article on #Hydroxychloroquine prophylaxis outcome. Assessing all POSSIBILITIES.
sciencedirect.com/science/articl…
sciencedirect.com/science/articl…
1/ Little Thread about all The Misleading Medical Information still floating around about #Hydroxychloroquine & #Chloroquine & #Azithromycin & #ZelenkoProtocol - by 1 doctor - @zev_dr & #Remdesivir & more
Despite #TrumpIsNotADoctor has stopped saying "What do you have to lose?".
Despite #TrumpIsNotADoctor has stopped saying "What do you have to lose?".
2/ #TrumpIsTheWORSTPresidentEVER
First, why it has been political all the way, suspected from day one:
"Trump had been touting HCQ for weeks, sparking worldwide shortages of HCQ & prompting negotiations with Indian PM Modi to lift export restrictions"
vanityfair.com/news/2020/04/i…
First, why it has been political all the way, suspected from day one:
"Trump had been touting HCQ for weeks, sparking worldwide shortages of HCQ & prompting negotiations with Indian PM Modi to lift export restrictions"
vanityfair.com/news/2020/04/i…
3/ #Trump2020
Indian PM Modi and Trump held a rally together.
"Mr Trump wanted to show people in the US that he was hugely popular abroad and that he was capable of negotiating good deals out of a country he once described as the king of tariffs"
bbc.com/news/world-sou…
Indian PM Modi and Trump held a rally together.
"Mr Trump wanted to show people in the US that he was hugely popular abroad and that he was capable of negotiating good deals out of a country he once described as the king of tariffs"
bbc.com/news/world-sou…
a "highly-(self)-cited" preprint from #raoult suggesting in vitro synergy of #hydrodroxychloroquine + #azithromycin against SARS-CoV-2 got accepted by Microbial Pathogenesis.
sciencedirect.com/science/articl…
a 18-day "serious" peer review happened
Let's see what we have(troll face)🔻
sciencedirect.com/science/articl…
a 18-day "serious" peer review happened
Let's see what we have(troll face)🔻
This paper is more like a beautiful mathematic proof - concise but "brilliant" -
"we proved that synergy is true. period"
Abstract: 93 words
Result: 143 words
🤣🤣🤣
"we proved that synergy is true. period"
Abstract: 93 words
Result: 143 words
🤣🤣🤣
Back to science, what is synergy?
In pharmacology, synergy is the observation that the outcome of a combination greater than individual. In plain word, 1+1 > 2.
Here is Fig 2A. A: az, H: hcq. number = concentration in uM.
WHERE IS THE Ct for HCQ & AZ ALONE ⁉️
In pharmacology, synergy is the observation that the outcome of a combination greater than individual. In plain word, 1+1 > 2.
Here is Fig 2A. A: az, H: hcq. number = concentration in uM.
WHERE IS THE Ct for HCQ & AZ ALONE ⁉️
🚨BREAKING: @US_FDA now warns that people should NOT take #chloroquine or #hydroxychloroquine—hawked by @realDonaldTrump—to treat #COVID19 outside a hospital or clinical trial, citing reports of “serious heart rhythm problems.”
As I warned 5 WEEKS ago.🤬
washingtonpost.com/world/2020/04/…
As I warned 5 WEEKS ago.🤬
washingtonpost.com/world/2020/04/…
Both #chloroquine and #hydroxychloroquine can alter the heart’s normal rhythm, leading to FATAL cardiac arrest.
Co-administration with #azithromycin (“Z pack”) can INCREASE the risk for this fatal side effect.🤬
Co-administration with #azithromycin (“Z pack”) can INCREASE the risk for this fatal side effect.🤬
FDA shockingly gave #hydroxychloroquine “emergency use authorization” (not a formal approval) for use in #COVID19 with ZERO supportive clinical evidence.
Did FDA cave to pressure from Trump⁉️
Did FDA cave to pressure from Trump⁉️
🚨BREAKING: major safety issues seen in a study in #Brazil of #chloroquine treatment for #coronavirus. 25% of patients taking the higher dose of chloroquine recommended by #China had irregular EKGs that increase risk of a fatal heart arrhythmia. 17% DIED.
nytimes.com/2020/04/12/hea…
nytimes.com/2020/04/12/hea…
🔥One of the authors of the study, Dr. Marcus Lacerda, said that his study found that “the high dosage (of #chloroquine) that the Chinese were using is very TOXIC and KILLS more patients.”
Yet @realDonaldTrump–who is NOT a doctor–keeps pushing its use.🤬
Yet @realDonaldTrump–who is NOT a doctor–keeps pushing its use.🤬
~50% of patients were given 450 mg of #chloroquine 2x/day for 5 days, while the rest were given 600 mg for 10 days. Within 3 days, heart arrhythmias were noted in patients at the higher dose. By the 6th day, 11 patients had DIED, immediately ending the high-dose treatment arm.
Em tempos de pandemia mundial pelo Covid19, faz-se necessário entender como são as fases da pesquisa clínica para aprovação e desenvolvimento de novos fármacos no mundo e porque esse processo é tão caro e rigoroso. #COVID19 #PesquisaClínica #MedicinaBaseadaemEvidência #CEP #CONEP
1) Para cada 10 mil novas moléculas descobertas pela indústria farmacêutica ou universidades, apenas 1 consegue chegar às farmácias e hospitais pois realmente comprova ser eficaz em todas as fases clínicas. O tempo mediano são de 10 anos e milhões a bilhões de dólares necessários
2) Falaremos inicialmente dos estudos pré-clínicos que ocorrem em laboratórios onde a hipótese (projeto científico) é testada “in vitro” -geralmente a medicação é usada contra células de ratos 🐭 sadias ou não-, para se comprovar atividade biológica daquela nova molécula criada.
(1/) An update of analysis of Dr. Raoult’s #hydroxychloroquine #azithromycin trial on 1061 patients.
mediterranee-infection.com/pre-prints-ihu/
(warning: it’ more like conspiracy theory)
mediterranee-infection.com/pre-prints-ihu/
(warning: it’ more like conspiracy theory)
(2/) Actually the preprints have two versions.
“Version 2”
mediterranee-infection.com/wp-content/upl…
Final version
mediterranee-infection.com/wp-content/upl…
There're minor changes in the final version compared to v2. Most are Ct values and HCQ serum concentrations. Other baseline characteristics are the same.
“Version 2”
mediterranee-infection.com/wp-content/upl…
Final version
mediterranee-infection.com/wp-content/upl…
There're minor changes in the final version compared to v2. Most are Ct values and HCQ serum concentrations. Other baseline characteristics are the same.
(3/) Another difference is the way that NEWS scores were presented.
Version 2. Mean-Sd-median-range.
Final version. Low-medium-high brackets.
Version 2. Mean-Sd-median-range.
Final version. Low-medium-high brackets.
kanye west was right when he said
“America eats its babies”
“America eats its babies”
mofos in Hollywood & mofos in politics been eating babies for years. literal years. look up #Adrenochrome
last time I tweeted about this I got targeted lol but it’s ok. times are a lil different now.
back then I didn’t know about Adrenochrome but it was the missing piece.
back then I didn’t know about Adrenochrome but it was the missing piece.
Starting a series on clinical Pearls I am gathering in #COVID19 patients based on experiences of many experts
Will add as we go along
Feel free to add your own observations/experiences
#covidclinicalpearls /1
Will add as we go along
Feel free to add your own observations/experiences
#covidclinicalpearls /1
Anosmia is likely the most specific #COVID19 related symptom
30% of patients have anosmia as their 1st symptom
#covidclinicalpearls /2
30% of patients have anosmia as their 1st symptom
#covidclinicalpearls /2
Around 90% of patients have fever.
50% maybe afebrile at the time of presentation
Fever tends to be very resistant to routine measures in hospitalized patients
There is no consensus that NSAIDs are to be avoided in #COVID2019 patients
#covidclinicalpearls /3
50% maybe afebrile at the time of presentation
Fever tends to be very resistant to routine measures in hospitalized patients
There is no consensus that NSAIDs are to be avoided in #COVID2019 patients
#covidclinicalpearls /3
@afneil The focus on ventilators is about as useful as focusing on whether we have enough coffins. There are more valuable interventions that are being totally ignored in uk at present. Let's run through them:
@afneil 1. Early intervention at home for ALL who develop mild #COVIDー19 symptoms - give them ALL a 5 day course of #chloroquine or #Hydroxychloroquine - this will prevent vast majority of severe cases needing to anywhere near a hospital
@afneil 2. Give PEP - post exposure prophylaxis of #chloroquine or #Hydroxychloroquine to the household members in a home where a person develops symptoms. Evidence is that most transmission is within the household. So stop the virus there!
THREAD 1/X Data available from NEW Chinese #Hydroxychloroquine #SARSCoV2 study conflicts with recent French #Hydroxychloroquine (and #Azithromycin) study touted by US politician. zjujournals.com/med/article/20… and mediterranee-infection.com/wp-content/upl… My thoughts:
2/X Both are small pilot studies and REQUIRE FURTHER VALIDATION. Viral load is the endpoint (not clinical outcome). This is important regardless because decrease shedding duration may have important #publichealth implications, and viral burden could impact cytokine storm risk
3/X French study is non-randomized, new Chinese study is randomized. This resulting imbalance in patient characteristics/disposition in French study raises lots of questions. Chinese study only published abstract, so more info is needed, but would tend to have more faith in it
Several studies in situ in Italy suggest that #hydroxychloroquine and #azithromycin have determinant effects over the ribosome RNA poly3' aaa sensitive polymerases, that are protein assembly units from RNA messenger into proteins.
It appears based on evidence (n=250), [not a randomised double-blind studies], that these two drugs have a synergistic effect in the hosts cells that make the virus partially unable to kidnap the ribosomes polymerase protein assembly of our cells.
Hydroxychloroquine is a zinc Inophore, which means it allows the external Zn to go inside the cell. Zn by itself is not easy to be carried inside the cells, however high amounts of Zn+2 inside the cell have the ability to reduce attachment of RNA 3'aaa dependent polymerases.
Ppl ask, why not try #Hydroxychlorquine and #Azithromycin for #SARSCov2 #COVID19. Here is some important info to know about the study sciencedirect.com/science/articl…
1. 20 HCQ pts (200 mg TID) & 16 controls with SARSCoV2
2. Pts w/ URTI, LRTI, or asx
3. 6 HCQ pts received Azithro x 5 d
1. 20 HCQ pts (200 mg TID) & 16 controls with SARSCoV2
2. Pts w/ URTI, LRTI, or asx
3. 6 HCQ pts received Azithro x 5 d
4. Pts received Azithro to prevent bacterial superinfxn
5. At day 6 post-inclusion 70% of HCQ pts were virologically cured vs 12.5% in control
6. At day 6 100% (6 pts ) with HCQ+Azithro were virologically cured vs 57.1% of HCQ only (14 pts) vs 12.5% in control (16 pts)
5. At day 6 post-inclusion 70% of HCQ pts were virologically cured vs 12.5% in control
6. At day 6 100% (6 pts ) with HCQ+Azithro were virologically cured vs 57.1% of HCQ only (14 pts) vs 12.5% in control (16 pts)
Although this data is potentially promising there are a few things to consider
1. This study is not powered for efficacy
2. Small sample size
3. No long term follow-up (although virologically cured unknown if it returned)
4. Unclear info on pt co-morbidities who received drugs
1. This study is not powered for efficacy
2. Small sample size
3. No long term follow-up (although virologically cured unknown if it returned)
4. Unclear info on pt co-morbidities who received drugs
Is #azithromycin (an antibiotic, not an antiviral) + #chloroquine (an antimalarial) effective?
Maybe, maybe not. This is why clinical trials are vital... even when the outcomes are negative.
nytimes.com/2020/03/18/hea…
Maybe, maybe not. This is why clinical trials are vital... even when the outcomes are negative.
nytimes.com/2020/03/18/hea…
meanwhile, when we have political leaders who don't understand science and the necessity of randomized clinical trials to demonstrate safety/efficacy...
nytimes.com/2020/03/20/hea…
nytimes.com/2020/03/20/hea…
here's the link to the clinical trial on hydroxychloroquine + azithromycin... NOT randomized, NOT blinded, only N=6 pts treated with combination treatment = take the results with a HUGE grain of salt
mediterranee-infection.com/hydroxychloroq…
mediterranee-infection.com/hydroxychloroq…
