Other Studies Indicating that Clarithromycin is a Good Option
for Covid-19:
Another exciting study made in Iran, experienced docking experiments
using the newly released coordinate structure for COVID-19 protease as a
receptor and nine drugs were selected from HIV-1 protease inhibitors and
twenty-one candidates from anti bronchitis drugs, based on their
chemical structures and enrolled them in blind and active site-directed
dockings in different modes and native-like conditions of interactions.
These experiments suggested that the binding capacity and the inhibitory
potency of those candidates were as follows: Tipranavir
>Indinavir>Atazanavir>Darunavir>Ritonavir>Amprenavir
for HIV-1, and
Cefditoren>Cefixime>Erythromycin>Clarithromycin
for anti-bronchitis medicines (82). In this context the author imagines
that a successful treatment regime should contain multi drugs of
protease inhibitors, spike shielding drugs, and immunomodulatory drugs
in early steps of the disease and Ivermectin>heparin (as
intravenous or nebulized)>macrolides seemed to them to be
good adjuvant candidates in all anti 2019-nCov regimes to shield S
protein even for prophylactic purposes (83).
Other small experiences appeared in the scientific literature later on
in a similar direction. One study in Taiwan, reported two cases with
community-acquired pneumonia caused by severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2) who returned from Wuhan, China. In hospital,
one patient positive for the virus remained febrile, malaise and poor
appetite. Follow-up CXR revealed increasing opacity at right middle and
lower lung fields. Levofloxacin was initiated. On hospital day 12, after
a 6-day course of Levofloxacin, her fever abated with improved appetite
and physical activity. She became free of symptoms afterward. The second
patient on day 6 in hospital, remained febrile, malaise and poor
appetite. She reported worsening of cough. Follow-up CXR revealed patchy
consolidation over bilateral lower lung field. Parenteral Cefepime and
oral Clarithromycin therapy were initiated. On day 9, she was afebrile
with improved general condition. Antimicrobial therapy was shifted to
oral Moxifloxacin. She remained free of symptoms afterward (84).
In Colombia, as published, one patient received clarithromycin instead
of azithromycin, in combination with chloroquine with the successful
recovery of COVID‐19 pneumonia, without any side adverse effects and
become negative for the SARS-CoV-2 infection, as observed in the RT-PCR
test. (85).
In Ecuador 12 patients were treated with a combination of
Clarithromycin, N-acetilcystine and an antiviral nutraceutical (Virusid)
with excellent outcomes (86).
Clarithromycin should be the best candidate to be tried for COVID-19
from all this evidence is obvious for us.