teedubbya wrote:the biologic basis for using azithromycin in this setting is unclear.
I assume they're referring to the general rule
"it's an antibiotic so it can't work against a virus only bacteria" however as I note above, azithromycin appears to be something of an odd, special case among antibiotics.
It's been observed to kill several virii (Zika, Ebola, etc.) in-vitro, and prescribing doctors have noticed for years that it seems to help significantly with viral infections (not just with secondary bacterial infections).
How (the mechanism) is not known, but it's been abundantly noticed over the years. It may be why it's so effective (at least in some places and according to some studies) when combined with hydroxychloroquine.
Great info by the way, thanks for the paste!
As to the question of why hydroxychloroquine + azithromycin works amazingly well in some places, and not at all in other places, I'm starting to wonder if the effect is much more precisely dosage-dependent than are the effect magnitudes of typical medications. Just look at the dosage range being used in the field in that paste above, the dosages are all over the map.
With many drugs, if you give a patient 200mg a day instead of 300mg..... or for another example, maybe 500mg instead of 600mg..... the outcome is pretty much the same. This particular 2-drug combo may be much more highly sensitive to dosage differences however... for example, 600mg a day may cure fully while 400mg does nothing (just to pull numbers out of my ass).
It would explain the wild differences in effectiveness, because the different sites are usually using different doses. It may be simply that small dosage differences cause very large outcome differences.
Gonna be interesting to see what the real answers end up being, months or years from now.
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