minocycline and Pneumonia--Viral

The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has rapidly grown into a public health emergency that has placed the national health systems as well as scientific research communities under enormous pressures. Drug repurposing or repositioning is a well-known strategy that seeks to deploy existing licensed drugs for newer indications and provides the quickest possible transition from bench to clinics for unmet therapeutic needs. Given the current, urgent, and dire need for effective therapies against novel coronavirus-19, this approach is particularly appealing.. Here, we review the significant anti-inflammatory, immunomodulatory, and antiviral properties of minocycline as potential mechanisms for efficacy against the novel coronavirus and highlight the promises and pitfalls of this approach.. As compared to other agents being investigated for COVID-19, minocycline offers distinct advantages in terms of potential efficacy in patients with life-threatening acute respiratory distress syndrome (ARDS) and myocardial injury, well-known safety and interaction profile, relatively low costs, and widespread availability. We call upon public and private funders to facilitate urgent and rigorous research efforts before evidence-based recommendations for its widespread use can be made.

Topics: Anti-Bacterial Agents; Betacoronavirus; Coronavirus Infections; COVID-19; Drug Repositioning; Humans; Minocycline; Pandemics; Pneumonia, Viral; SARS-CoV-2

Patients with moderate to severe COVID-19 infection require specific drugs to prevent the morbidity and mortality. Hydroxychloroquine (HCQ) has shown some promise in the management of COVID 19. Minocycline, because of its anticytokine and other useful properties can be an ideal candidate for combining with HCQ.. Here we review the need and mechanisms and reasons for combining HCQ and minocycline moderate to severe COVID-19 infection. We also reviewed the advantages, potential safety concerns and precautions to be taken, while combining HCQ and minocycline.. Combining HCQ and minocycline offers many advantages in the management of moderate to severe COVID-19 infection. Both drugs are cheaper, widely available and long-term safety data and contraindications are well known. We do not recommend this combination for prophylaxis or use in asymptomatic or mild disease patients as this can lead to unnecessary safety concerns. Additive antimicrobial and anticytokine effects of both drugs may reduce the morbidity and mortality among patients with COVID-19 and may act as a cheaper alternative to the costlier drugs, however, thorough clinical research is warranted. We call upon public and private healthcare bodies to come up with large well-designed clinical studies for generating evidence-based recommendations.

Topics: Anti-Infective Agents; Coronavirus Infections; COVID-19; COVID-19 Drug Treatment; Drug Therapy, Combination; Humans; Hydroxychloroquine; Minocycline; Pandemics; Pneumonia, Viral; Severity of Illness Index

Topics: Adenoviridae; Adenoviridae Infections; Bacterial Infections; Clinical Trials as Topic; Humans; Influenza, Human; Lung; Minocycline; Neisseria meningitidis; Orthomyxoviridae; Paramyxoviridae Infections; Pneumonia; Pneumonia, Viral; Respiratory System; Respirovirus; Sputum; Tetracycline; Trachea

We report two cases of severe bronchopneumonia due to influenza A (H3N2) virus. The severity of the disease necessitated initiation of empiric therapy based on the present illness and clinical data on admission. Both patients were improved by artificial ventilation with positive end-expiratory pressures and administration of broad spectrum antibiotics and corticosteroids before confirming the diagnosis of viral bronchopneumonia using viral culture and serological tests. Within 24 hours, influenza A (H3N2) virus was identified by amplification of the pathogen genes by reverse transcription polymerase chain reaction (RT-PCR) using the stored bronchoalveolar lavage (BAL) fluids of both cases. This suggests that a combination of detection methods of pathogens using RT-PCR and BAL fluid will facilitate determination of rational treatment aimed at influenza A virus.

Topics: Aged; Antibiotic Prophylaxis; Betamethasone; Bronchoalveolar Lavage Fluid; Bronchopneumonia; Cephalosporins; Clindamycin; Combined Modality Therapy; Drug Therapy, Combination; Fosfomycin; Humans; Influenza A virus; Influenza A Virus, H3N2 Subtype; Male; Methylprednisolone; Middle Aged; Minocycline; Pneumonia, Viral; Positive-Pressure Respiration; Respiration, Artificial; Reverse Transcriptase Polymerase Chain Reaction; RNA, Viral

Topics: Acyclovir; DNA, Viral; Erythromycin; Humans; Minocycline; Nucleic Acid Hybridization; Pneumonia, Mycoplasma; Pneumonia, Viral; Polymerase Chain Reaction; RNA, Viral