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Covid is caused by a virus. Why antibiotics?

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Many times in these two years of pandemic we have heard of patients with serious forms of covid also treated with antibiotics: but is this group of drugs not reserved for bacterial infections? Why use them against SARS-CoV-2 disease? The question is at the heart of an article on The Conversation.

Antibiotics, bacteria and viruses. As we know, using antibiotics against flu and colds is completely useless because their use is reserved for bacterial infections, and used inappropriately they feed the selection of drug-resistant super bacteria.

Yet, especially in hospital settings, some classes of antibiotics are used to alleviate the symptoms of covid, which is a viral infection. For example, a study by Beni-Suef University in Egypt concluded that the use of ceftazidime or cefepime, two antibiotics of the beta-lactam family, in patients with moderate or severe covid leads to similar results compared to one treatment ” standard “authorized by the WHO that includes seven different types of drugs. In short, the use of one or the other antibiotic is simpler care, both for the patient and for the healthcare system.

New uses for old drugs. The search for an effective antiviral against covid continues unabated (and with some promising results), but a tailor-made drug against the new coronavirus will take time, and the millions of critically ill patients cannot wait. This is why in this pandemic, as was already done for other health emergencies from viruses such as Ebola, Zika or MERS, extensive use was made of existing drugs whose tolerability and safety had already been established.

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It is the so-called drug repurposing, that is the “repositioning” of medicines born for different purposes but which are able to inhibit viral multiplication, improve the state of health of patients or strengthen their immune system.

Wear on the hips. Some viruses, although very different from bacteria, are indeed sensitive to the action of antibiotics. For example, during the Zika epidemic it was discovered that azithromycin, an antibiotic used to treat respiratory infections, taken during pregnancy inhibited the replication of the virus in the brains of fetuses, and could protect against microcephaly (impaired brain growth). ) in case the mother was infected. Another antibiotic, novobiocin, seems to have a strong antiviral action against both the Zika virus and that of dengue.

These results suggest that some antibiotics may actually effectively hinder the action of SARS-CoV-2, and that taking “antibiotics only for bacteria” may allow for some exceptions.

Useful for secondary infections. Ceftazidime and cefepime would be able to destroy the coronavirus protease, an enzyme essential for the reproduction of the pathogen. This is suggested by computer simulations that usually anticipate actual in vitro studies. Both are also part of the broad spectrum antibiotics used to eradicate infections affecting already severely debilitated patients admitted to hospital.

As patients with covid also often end up contracting co-infections, these drugs could improve their condition: in fact, it is not clear whether the results reported by the Egyptian study depend on the action of antibiotics on concomitant infections or on the inhibition of the coronavirus. real, which avoids pneumonia for example.

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better to prevent. While we await effective antiviral treatments, we remember that the best tool available to ward off severe forms of covid is the vaccine. We cannot place expectations and trust in drugs born for different uses, both because no one is, at the moment, life saving, and because the massive use of antibiotics for severe cases of covid has already given a decisive acceleration to the phenomenon of antibiotic resistance, a serious threat to public health.

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