Clarithromycin (CAM) has diverse effects like immunomodulatory and immunosuppressive effects, autophagy inhibition, steroid spanning effect, reversibility of drug resistance, antineoplastic and antiviral effects. Recently it has been proven that CAM successfully suppresses inflammatory cytokines responsible for cytokine release syndrome (CRS) and possesses an anti-SARS-CoV-2 effect. CAM leads to the suppression of the RdRp gene, resulting in the inhibition of SARS-CoV-2 replication. An open-labeled non-randomized trial was initiated in May 2020, in which 90 COVID-19 patients were administered with CAM 500 mg and additional 90 patients were given a combination of azithromycin and hydroxychloroquine. It was found that the incidence of severe respiratory failure was 12.2% among patients treated with CAM versus 26.7% among patients without CAM treatment.
Furthermore, CAM helps in the suppression of SARS-CoV-2 relative viral load. The viral load of SARS-CoV-2 in the nasopharynx of CAM-treated patients was significantly reduced on day 4 and day 8 after treatment initiation. Usually, CAM has mild adverse effects. But, CAM therapy is not recommended for patients with a history of arrhythmia and QT prolongation.
Thus, treatment with CAM alone or in combination with other antiviral and antibacterial drugs might serve as a promising strategy to fight against COVID-19. The widespread availability of CAM with an already established safety profile makes CAM a safer option for treating COVID-19. Considering the antiviral and immunomodulatory effects of CAM, it is likely that CAM will be effective against the variants of COVID-19. But, further studies are needed to thoroughly assess the efficacy of CAM against COVID-19.
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Source: Tropical Biomedicine