zithromax and Diabetes-Mellitus

Topics: Anti-Bacterial Agents; Azithromycin; Bacteria; Diabetes Mellitus; Glucose; Glucose Oxidase; Humans; Hydrogen Peroxide; Wound Healing; Wound Infection

Limited data are available on the clinical presentation and outcomes of coronavirus disease (COVID-19) patients in the United States hospitalized under normal-caseload or nonsurge conditions. We retrospectively studied 72 consecutive adult patients hospitalized with COVID-19 in 2 hospitals in the San Francisco Bay area, California, USA, during March 13-April 11, 2020. The death rate for all hospitalized COVID-19 patients was 8.3%, and median length of hospitalization was 7.5 days. Of the 21 (29% of total) intensive care unit patients, 3 (14.3% died); median length of intensive care unit stay was 12 days. Of the 72 patients, 43 (59.7%) had underlying cardiovascular disease and 19 (26.4%) had underlying pulmonary disease. In this study, death rates were lower than those reported from regions of the United States experiencing a high volume of COVID-19 patients.

Topics: Adenosine Monophosphate; Aged; Aged, 80 and over; Alanine; Asthma; Azithromycin; Betacoronavirus; California; Clinical Laboratory Techniques; Comorbidity; Coronavirus Infections; COVID-19; COVID-19 Testing; Diabetes Mellitus; Female; Humans; Hyperlipidemias; Hypertension; Intensive Care Units; Length of Stay; Male; Pandemics; Pneumonia, Viral; Pulmonary Disease, Chronic Obstructive; Retrospective Studies; Reverse Transcriptase Polymerase Chain Reaction; SARS-CoV-2; Severity of Illness Index; Survival Analysis; Tomography, X-Ray Computed

Topics: Azithromycin; Betacoronavirus; Coronavirus Infections; COVID-19; COVID-19 Drug Treatment; Diabetes Mellitus; Glucosephosphate Dehydrogenase Deficiency; Hemolysis; Humans; Hydroxychloroquine; Male; Methemoglobinemia; Middle Aged; Obesity, Morbid; Pandemics; Pneumonia, Viral; SARS-CoV-2

Invasive mechanical has been associated with high mortality in COVID-19. Alternative therapy of high flow nasal therapy (HFNT) has been greatly debated around the world for use in COVID-19 pandemic due to concern for increased healthcare worker transmission.This was a retrospective analysis of consecutive patients admitted to Temple University Hospital in Philadelphia, Pennsylvania, from 10 March 2020 to 24 April 2020 with moderate-to-severe respiratory failure treated with HFNT. Primary outcome was prevention of intubation. Of the 445 patients with COVID-19, 104 met our inclusion criteria. The average age was 60.66 (+13.50) years, 49 (47.12 %) were female, 53 (50.96%) were African-American, 23 (22.12%) Hispanic. Forty-three patients (43.43%) were smokers. Saturation to fraction ratio and chest X-ray scores had a statistically significant improvement from day 1 to day 7. 67 of 104 (64.42%) were able to avoid invasive mechanical ventilation in our cohort. Incidence of hospital-associated/ventilator-associated pneumonia was 2.9%. Overall, mortality was 14.44% (n=15) in our cohort with 13 (34.4%) in the progressed to intubation group and 2 (2.9%) in the non-intubation group. Mortality and incidence of pneumonia was statistically higher in the progressed to intubation group. CONCLUSION: HFNT use is associated with a reduction in the rate of invasive mechanical ventilation and overall mortality in patients with COVID-19 infection.

Topics: Adrenal Cortex Hormones; Aged; Anti-Bacterial Agents; Antibodies, Monoclonal, Humanized; Antirheumatic Agents; Azithromycin; Betacoronavirus; Black or African American; Cannula; Comorbidity; Coronavirus Infections; COVID-19; Diabetes Mellitus; Female; Healthcare-Associated Pneumonia; Heart Diseases; Hispanic or Latino; Humans; Hydroxychloroquine; Hypertension; Hypoxia; Immunoglobulins, Intravenous; Immunologic Factors; Intubation, Intratracheal; Lung Diseases; Male; Middle Aged; Oxygen Inhalation Therapy; Pandemics; Philadelphia; Pneumonia, Ventilator-Associated; Pneumonia, Viral; Pulse Therapy, Drug; Renal Insufficiency, Chronic; Respiratory Insufficiency; Retrospective Studies; SARS-CoV-2; Severity of Illness Index; Smoking; White People

We developed a semi-automated active monitoring system that uses sequential matched-cohort analyses to assess drug safety across a distributed network of longitudinal electronic health-care data. In a retrospective analysis, we show that the system would have identified cerivastatin-induced rhabdomyolysis. In this study, we evaluated whether the system would generate alerts for three drug-outcome pairs: rosuvastatin and rhabdomyolysis (known null association), rosuvastatin and diabetes mellitus, and telithromycin and hepatotoxicity (two examples for which alerting would be questionable). Over >5 years of monitoring, rate differences (RDs) in comparisons of rosuvastatin with atorvastatin were -0.1 cases of rhabdomyolysis per 1,000 person-years (95% confidence interval (CI): -0.4, 0.1) and -2.2 diabetes cases per 1,000 person-years (95% CI: -6.0, 1.6). The RD for hepatotoxicity comparing telithromycin with azithromycin was 0.3 cases per 1,000 person-years (95% CI: -0.5, 1.0). In a setting in which false positivity is a major concern, the system did not generate alerts for the three drug-outcome pairs.

Topics: Aged; Anti-Bacterial Agents; Azithromycin; Chemical and Drug Induced Liver Injury; Diabetes Mellitus; Drug Monitoring; Electronic Data Processing; Electronic Health Records; Female; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Ketolides; Male; Outcome Assessment, Health Care; Product Surveillance, Postmarketing; Retrospective Studies; Rhabdomyolysis

Topics: Anti-Bacterial Agents; Azithromycin; Cystic Fibrosis; Diabetes Mellitus; Humans; Infection Control; North America; Pseudomonas Infections; Quality Assurance, Health Care; Survival Analysis; Vitamin D; Vitamins

To compare serum and intracellular pharmacokinetics of azithromycin in healthy volunteers and patients with diabetes.. Open-label, parallel study.. Clinical research center.. Twelve patients with diabetes and 12 healthy volunteers.. Subjects were given a single 500-mg dose of azithromycin followed by 250 mg/day for 2 days. Blood samples were obtained just before and after the third dose for up to 24 hours for serum and 168 hours for intracellular measurement of azithromycin.. Pharmacokinetic parameters were calculated by noncompartmental methods and compared with a t test. The groups did not differ in maximum concentration, time to maximum concentration, or area under the concentration-time curve in serum or polymorphonuclear cells (PMNs). Differences in the PMN:serum ratio were observed at the 24-hour time point (healthy 1209 +/- 432, diabetic 859 +/- 286, p=0.051).. In general, the pharmacokinetics of azithromycin are comparable in diabetics and healthy volunteers. Accumulation of drug in macrophages was slightly lower in patients.

Topics: Adult; Anti-Bacterial Agents; Azithromycin; Diabetes Mellitus; Female; Humans; Male; Neutrophils