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1. What is the evidence for use of macrolide antibiotics for treatment of COVID-19?

What is the evidence for use of macrolide antibiotics for treatment of COVID-19? What is the evidence for use of macrolide antibiotics for treatment of COVID-19? - CEBM CEBM The Centre for Evidence-Based Medicine develops, promotes and disseminates better evidence for healthcare. Navigate this website What is the evidence for use of macrolide antibiotics for treatment of COVID-19? April 28, 2020 Kome Gbinigie and Kerstin Frie On behalf of the Oxford COVID-19 Evidence Service Team Centre (...) for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences University of Oxford Correspondence to VERDICT We identified three studies, two in vitro and one in vivo , assessing the use of macrolide antibiotics for the treatment of COVID-19. Each of these studies assessed treatment with azithromycin. The evidence from the in vivo study and one in vitro study suggest a possible synergy between azithromycin and hydroxychloroquine. However, the in vivo study had a small number

2020 Oxford COVID-19 Evidence Service

2. Adverse events in people taking macrolide antibiotics versus placebo for any indication. (Full text)

Adverse events in people taking macrolide antibiotics versus placebo for any indication. Macrolide antibiotics (macrolides) are among the most commonly prescribed antibiotics worldwide and are used for a wide range of infections. However, macrolides also expose people to the risk of adverse events. The current understanding of adverse events is mostly derived from observational studies, which are subject to bias because it is hard to distinguish events caused by antibiotics from events caused (...) by the diseases being treated. Because adverse events are treatment-specific, rather than disease-specific, it is possible to increase the number of adverse events available for analysis by combining randomised controlled trials (RCTs) of the same treatment across different diseases.To quantify the incidences of reported adverse events in people taking macrolide antibiotics compared to placebo for any indication.We searched the Cochrane Central Register of Controlled Trials (CENTRAL), which includes

2019 Cochrane PubMed abstract

3. BTS Guideline for Long Term Macrolide Use

BTS Guideline for Long Term Macrolide Use British Thoracic Society guideline for the use of long- term macrolides in adults with respiratory disease David Smith, 1 Ingrid Du Rand, 2 Charlotte Louise Addy, 3 Timothy Collyns, 4 Simon Paul Hart , 5 Philip J Mitchelmore , 6,7 Najib M Rahman, 8 Ravijyot Saggu 9 BTS Guideline To cite: Smith D, Du Rand I, Addy CL, et al. Thorax Epub ahead of print: [please include Day Month Year]. doi:10.1136/ thoraxjnl-2019-213929 ? Additional material is published (...) . smith@ nbt. nhs . uk ? http:// dx. doi . org/ 10. 1136/ thor axjnl- 2019- 214039 © Author(s) (or their employer(s)) 2020. No commercial re- use. See rights and permissions. Published by BMJ. SUMMARY OF RECOMMENDATIONS AND GOOD PRACTICE POINTS Asthma Recommendations ? Oral macrolide therapy could be considered to reduce exacerbation frequency in adults (50–70 years), with ongoing symptoms despite >80% adherence to high- dose inhaled steroids (>800 µg/day) and at least one exacerbation requiring oral

2020 British Thoracic Society

4. Macrolide antibiotics for bronchiectasis. (Full text)

Macrolide antibiotics for bronchiectasis. Bronchiectasis is a chronic respiratory disease characterised by abnormal and irreversible dilatation and distortion of the smaller airways. Bacterial colonisation of the damaged airways leads to chronic cough and sputum production, often with breathlessness and further structural damage to the airways. Long-term macrolide antibiotic therapy may suppress bacterial infection and reduce inflammation, leading to fewer exacerbations, fewer symptoms (...) , improved lung function, and improved quality of life. Further evidence is required on the efficacy of macrolides in terms of specific bacterial eradication and the extent of antibiotic resistance.To determine the impact of macrolide antibiotics in the treatment of adults and children with bronchiectasis.We identified trials from the Cochrane Airways Trials Register, which contains studies identified through multiple electronic searches and handsearches of other sources. We also searched trial

2018 Cochrane PubMed abstract

5. Comparison of ceftriaxone plus macrolide and ampicillin/sulbactam plus macrolide in treatment for patients with community-acquired pneumonia without risk factors for aspiration: an open-label, quasi-randomized, controlled trial. (Full text)

Comparison of ceftriaxone plus macrolide and ampicillin/sulbactam plus macrolide in treatment for patients with community-acquired pneumonia without risk factors for aspiration: an open-label, quasi-randomized, controlled trial. Ceftriaxone (CTRX) and ampicillin/sulbactam (ABPC/SBT) are recommended by various guidelines as the first-line antibiotics for community-acquired pneumonia (CAP). However, which of these antibiotics is more effective for treating non-aspiration CAP remains unclear.This (...) study was a prospective, single-center, open-label, quasi-randomized controlled trial. Patients with adult CAP without risk for aspiration were allocated to either a CTRX or ABPC/SBT group based on the date of hospital admission. Macrolide was added to patients in each group. The primary outcome was the clinical response in the validated per-protocol (VPP) population at end of treatment (EOT). The secondary outcomes were clinical response during treatment and at end of study (EOS) in the VPP

2020 BMC pulmonary medicine PubMed abstract

6. Macrolides for treatment of Haemophilus ducreyi infection in sexually active adults. (Full text)

Macrolides for treatment of Haemophilus ducreyi infection in sexually active adults. Chancroid is a genital ulcerative disease caused by Haemophilus ducreyi. This microorganism is endemic in Africa, where it can cause up to 10% of genital ulcers. Macrolides may be an effective alternative to treat chancroid and, based on their oral administration and duration of therapy, could be considered as first line therapy.To assess the effectiveness and safety of macrolides for treatment of H ducreyi (...) infection in sexually active adults.We searched the Cochrane STI Group Specialized Register, CENTRAL, MEDLINE, Embase, LILACS, WHO ICTRP, ClinicalTrials.gov and Web of Science to 30 October 2017. We also handsearched conference proceedings and reference lists of retrieved studies.Randomized controlled trials (RCTs) comparing macrolides in different regimens or with other therapeutic alternatives for chancroid.Two review authors independently assessed trials for inclusion, extracted data and assessed

2017 Cochrane PubMed abstract

7. Prescription of macrolides vs penicillin during pregnancy was linked to major malformations in offspring. (Abstract)

Prescription of macrolides vs penicillin during pregnancy was linked to major malformations in offspring. Fan H, Gilbert R, O'Callaghan F, Li L. Associations between macrolide antibiotics prescribing during pregnancy and adverse child outcomes in the UK: population based cohort study. BMJ. 2020;368:m331. 32075790.

2020 Annals of Internal Medicine

8. Associations between macrolide antibiotics prescribing during pregnancy and adverse child outcomes in the UK: population based cohort study. (Full text)

Associations between macrolide antibiotics prescribing during pregnancy and adverse child outcomes in the UK: population based cohort study. To assess the association between macrolide antibiotics prescribing during pregnancy and major malformations, cerebral palsy, epilepsy, attention deficit hyperactivity disorder, and autism spectrum disorder in children.Population based cohort study.The UK Clinical Practice Research Datalink.The study cohort included 104 605 children born from 1990 to 2016 (...) whose mothers were prescribed one macrolide monotherapy (erythromycin, clarithromycin, or azithromycin) or one penicillin monotherapy from the fourth gestational week to delivery. Two negative control cohorts consisted of 82 314 children whose mothers were prescribed macrolides or penicillins before conception, and 53 735 children who were siblings of the children in the study cohort.Risks of any major malformations and system specific major malformations (nervous, cardiovascular, gastrointestinal

2020 BMJ PubMed abstract

9. RETRACTED: Hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysis. (Full text)

RETRACTED: Hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysis. Hydroxychloroquine or chloroquine, often in combination with a second-generation macrolide, are being widely used for treatment of COVID-19, despite no conclusive evidence of their benefit. Although generally safe when used for approved indications such as autoimmune disease or malaria, the safety and benefit of these treatment regimens are poorly evaluated (...) in COVID-19.We did a multinational registry analysis of the use of hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19. The registry comprised data from 671 hospitals in six continents. We included patients hospitalised between Dec 20, 2019, and April 14, 2020, with a positive laboratory finding for SARS-CoV-2. Patients who received one of the treatments of interest within 48 h of diagnosis were included in one of four treatment groups (chloroquine alone, chloroquine

2020 Lancet PubMed abstract

10. British Thoracic Society guideline for the use of long-term macrolides in adults with respiratory disease (Full text)

British Thoracic Society guideline for the use of long-term macrolides in adults with respiratory disease British Thoracic Society Guideline for the Use of Long-Term Macrolides in Adults With Respiratory Disease - PubMed This site needs JavaScript to work properly. Please enable it to take advantage of the complete set of features! Clipboard, Search History, and several other advanced features are temporarily unavailable. National Institutes of Health National Library of Medicine National (...) Actions . 2020 May;75(5):370-404. doi: 10.1136/thoraxjnl-2019-213929. Epub 2020 Apr 17. British Thoracic Society Guideline for the Use of Long-Term Macrolides in Adults With Respiratory Disease , , , , , , , Affiliations Expand Affiliations 1 North Bristol Lung Centre, Southmead Hospital, Bristol, UK david.smith@nbt.nhs.uk. 2 Respiratory, Wye Valley NHS Trust, Hereford, UK. 3 Centre for Medical Education, Queens University Belfast, Regional Respiratory Centre, Belfast City Hospital, Belfast, UK. 4

2020 EvidenceUpdates PubMed abstract

11. Therapeutic efficacy of azithromycin, clarithromycin, minocycline and tosufloxacin against macrolide-resistant and macrolide-sensitive Mycoplasma pneumoniae pneumonia in pediatric patients. (Full text)

Therapeutic efficacy of azithromycin, clarithromycin, minocycline and tosufloxacin against macrolide-resistant and macrolide-sensitive Mycoplasma pneumoniae pneumonia in pediatric patients. To clarify therapeutic effects of azithromycin, clarithromycin, minocycline and tosufloxacin against macrolide-resistant Mycoplasma pneumoniae (MRMP) pneumonia and against macrolide-sensitive Mycoplasma pneumoniae (MSMP) pneumonia in pediatric patients.A prospective, multicenter observational study (...) with MRMP compared to the duration of fever in patients treated with macrolides.

2017 PLoS ONE PubMed abstract

12. Mechanism of macrolide-induced inhibition of pneumolysin release involves impairment of autolysin release in macrolide-resistant <i>Streptococcus pneumoniae</i>. (Full text)

Mechanism of macrolide-induced inhibition of pneumolysin release involves impairment of autolysin release in macrolide-resistant Streptococcus pneumoniae. Streptococcus pneumoniae is a leading cause of community-acquired pneumonia. Over the past 2 decades, macrolide resistance among S. pneumoniae organisms has been increasing steadily and has escalated at an alarming rate worldwide. However, the use of macrolides in the treatment of community-acquired pneumonia has been reported (...) to be effective regardless of the antibiotic susceptibility of the causative pneumococci. Although previous studies suggested that sub-MICs of macrolides inhibit the production of the pneumococcal pore-forming toxin pneumolysin by macrolide-resistant S. pneumoniae (MRSP), the underlying mechanisms of the inhibitory effect have not been fully elucidated. Here, we show that the release of pneumococcal autolysin, which promotes cell lysis and the release of pneumolysin, was inhibited by treatment

2018 Antimicrobial Agents and Chemotherapy PubMed abstract

13. Prevalence of macrolide resistance in Treponema pallidum is associated with macrolide consumption. (Full text)

Prevalence of macrolide resistance in Treponema pallidum is associated with macrolide consumption. We hypothesized that the large global variations in the prevalence of macrolide resistance in Treponema pallidum are related to differences in population-level macrolide consumption. The hypothesis was tested by, at a country-level, regressing the peak prevalence of macrolide resistance against the national macrolide consumption in the year prior to this, controlling for the year of the resistance (...) prevalence estimate. A strong association was found between the per capita consumption of macrolides and macrolide resistance (coefficient 0.7, 95 % confidence interval 0.2-0.12, P=0.009).

2018 Journal of Medical Microbiology PubMed abstract

14. Therapeutic Efficacy and Safety of Prolonged Macrolide, Corticosteroid, Doxycycline, and Levofloxacin against Macrolide-Unresponsive Mycoplasma pneumoniae Pneumonia in Children (Full text)

Therapeutic Efficacy and Safety of Prolonged Macrolide, Corticosteroid, Doxycycline, and Levofloxacin against Macrolide-Unresponsive Mycoplasma pneumoniae Pneumonia in Children We aimed to compare the therapeutic efficacy of prolonged macrolide (PMC), corticosteroids (CST), doxycycline (DXC), and levofloxacin (LFX) against macrolide-unresponsive Mycoplasma pneumoniae (MP) pneumonia in children and to evaluate the safety of the secondary treatment agents.We retrospectively analyzed the data (...) of patients with MP pneumonia hospitalized between January 2015 and April 2017. Macrolide-unresponsiveness was clinically defined with a persistent fever of ≥ 38.0°C at ≥ 72 hours after macrolide treatment. The cases were divided into four groups: PMC, CST, DXC, and LFX. We compared the time to defervescence (TTD) after secondary treatment and the TTD after initial macrolide treatment in each group with adjustment using propensity score-matching analysis.Among 1,165 cases of MP pneumonia, 190 (16.3%) were

2018 Journal of Korean medical science PubMed abstract

15. Evaluation of the Lightmix<sup>®</sup>Mycoplasma macrolide assay for the detection of macrolide resistant Mycoplasma pneumoniae in pneumonia patients. (Full text)

Evaluation of the Lightmix®Mycoplasma macrolide assay for the detection of macrolide resistant Mycoplasma pneumoniae in pneumonia patients. Rapid detection of macrolide resistance-associated mutations in Mycoplasma pneumoniae is crucial for effective antimicrobial treatment. We evaluated the Lightmix Mycoplasma macrolide assay for the detection of point mutations at nucleotide positions 2063 and 2064 in the 23S ribosomal RNA (rRNA) gene of M. pneumoniae that confer macrolide (...) ) and a specificity of 100% (95% confidence interval, 97.5-100) as the detected M. pneumoniae genotype (148 wild type and 15 non-wild type) was confirmed by 23S rRNA sequencing in all samples.The Lightmix assay is an easy-to-use and accurate molecular test that allows rapid determination of macrolide resistance in M. pneumoniae.Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

2018 Clinical Microbiology and Infection PubMed abstract

16. Tailored Helicobacter pylori eradication based on prior intake of macrolide antibiotics allows the use of triple therapy with optimal results in an area with high clarithromycin resistance. (Full text)

Tailored Helicobacter pylori eradication based on prior intake of macrolide antibiotics allows the use of triple therapy with optimal results in an area with high clarithromycin resistance. the previous intake of macrolide antibiotics is associated with a failure to eradicate Helicobacter pylori (H. pylori) with clarithromycin-containing regimens. However, the standard triple therapy achieves eradication rates of over 90% in patients without a previous use of macrolides in our health area (...) . The aim of this study was to evaluate the efficacy of an H. pylori eradication strategy based on the intake of macrolides by the patient during the previous years.one hundred and sixty-nine patients with H. pylori infection were prospectively included in the study. The electronic medical record of each patient was reviewed at the time of inclusion. Depending on their previous intake of macrolides, patients were assigned to one of two eradication regimens: group A) patients without a previous intake

2019 Revista espanola de enfermedades digestivas : organo oficial de la Sociedad Espanola de Patologia Digestiva Controlled trial quality: uncertain PubMed abstract

17. Macrolides for diffuse panbronchiolitis. (Full text)

Macrolides for diffuse panbronchiolitis. Diffuse panbronchiolitis (DPB) is a chronic airways disease predominantly affecting East Asians. Macrolides, a class of antibiotics, have been used as the main treatment for DPB, based on evidence from retrospective and non-randomised studies.To assess the efficacy and safety of macrolides for DPB.We searched CENTRAL (2014, Issue 6), MEDLINE (1966 to July week 1, 2014), EMBASE (1974 to July 2014), Chinese Biomedical Literature Database (CBM) (1978 (...) to July 2014), China National Knowledge Infrastructure (CNKI) (1974 to July 2014), KoreaMed (1997 to July 2014) and Database of Japana Centra Revuo Medicina (1983 to July 2014).Randomised controlled trials (RCTs) or quasi-RCTs assessing the effect of macrolides for DPB.Two review authors independently assessed study quality and subsequent risk of bias according to The Cochrane Collaboration's tool for assessing risk of bias. The primary outcomes were five-year survival rate, lung function and clinical

2015 Cochrane PubMed abstract

18. Macrolides for chronic asthma. (Full text)

Macrolides for chronic asthma. Asthma is a chronic disease in which inflammation of the airways causes symptomatic coughing, wheezing, and difficult breathing. The inflammation may have different underlying causes, including a reaction to infection in the lungs. Macrolides are antibiotics with antimicrobial and antiinflammatory activities that have been used long-term to control asthma symptoms.To assess the effects of macrolides for managing chronic asthma.We searched the Cochrane Airways (...) Group Specialised Register up to April 2015. We also manually searched bibliographies of previously published reviews and conference proceedings and contacted study authors. We included records published in any language in the search.Randomised controlled clinical trials involving both children and adults with chronic asthma treated with macrolides versus placebo for more than four weeks .Two reviewers independently examined all records identified in the searches then reviewed the full text of all

2015 Cochrane PubMed abstract

19. A Population-Based Assessment of the Impact of 7- and 13-Valent Pneumococcal Conjugate Vaccines on Macrolide-Resistant Invasive Pneumococcal Disease: Emergence and Decline of Streptococcus pneumoniae Serotype 19A (CC320) With Dual Macrolide Resistance Mec (Full text)

A Population-Based Assessment of the Impact of 7- and 13-Valent Pneumococcal Conjugate Vaccines on Macrolide-Resistant Invasive Pneumococcal Disease: Emergence and Decline of Streptococcus pneumoniae Serotype 19A (CC320) With Dual Macrolide Resistance Mec Macrolide efflux encoded by mef(E)/mel and ribosomal methylation encoded by erm(B) confer most macrolide resistance in Streptococcus pneumoniae. Introduction of the heptavalent pneumococcal conjugate vaccine (PCV7) in 2000 reduced macrolide (...) -resistant invasive pneumococcal disease (MR-IPD) due to PCV7 serotypes (6B, 9V, 14, 19F, and 23F).In this study, the impact of PCV7 and PCV13 on MR-IPD was prospectively assessed. A 20-year study of IPD performed in metropolitan Atlanta, Georgia, using active, population-based surveillance formed the basis for this study. Genetic determinants of macrolide resistance were evaluated using established techniques.During the decade of PCV7 use (2000-2009), MR-IPD decreased rapidly until 2002 and subsequently

2017 Clinical Infectious Diseases PubMed abstract

20. Development of macrolide resistance-associated mutations after macrolide treatment in children infected with Mycoplasma pneumoniae. (Full text)

Development of macrolide resistance-associated mutations after macrolide treatment in children infected with Mycoplasma pneumoniae. To determine the timing of the emergence of macrolide-resistant mutations after macrolide treatment in individuals with Mycoplasma pneumoniae infections.Between October 2011 and December 2013, serial pharyngeal swab specimens were collected before and after macrolide treatment from 21 otherwise healthy children infected with M. pneumoniae without macrolide (...) -resistant mutations. The copy numbers of a M. pneumoniae gene and the proportion of clones showing macrolide-resistance mutations were determined for each specimen.After macrolide treatment (10-15 mg kg-1 day-1 clarithromycin for 5-10 days or 10 mg kg-1 day-1 azithromycin for 3 days), fever resolved in 19 (90 %) of 21 children within 1 to 2 days, and the M. pneumoniae gene copy number decreased in all but one specimen in the second set of specimens relative to the number in the corresponding initial

2017 Journal of Medical Microbiology PubMed abstract

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