Cotrimoxazole as adjuvant therapy in critical ill COVID 19 patients
The ongoing pandemic of COVID-19 has forced us to consider using available drugs in the shortfall of vaccines and established treatment. Cotrimoxazole is one of the oldest drugs presently used in the prevention and treatment of opportunistic infections in the human immune deficiency virus (HIV) etc. It is a combination of two drugs Trimethoprim and Sulfamethoxazole. This cost-effective old drug is well tolerated among the population with the concomitant use of folic acid; moreover, it also looks after the secondary infections. To conclude, Cotrimoxazole can be used as critically ill COVID-19 patients. References • Ruan Q, Yang K, Wang W, Jiang L, Song J. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive care Med. 2020;46(5): 846–48. https://doi.org/10.1007/s00134-020-05991-x • Rozin A, Schapira D, Braun-Moscovici Y, Nahir AM. Cotrimoxazole treatment for rheumatoid arthritis. Semin Arthritis Rheum. 2001;31(2):133-41. • Bourke CD, Gough EK, Pimundu G, Shonhai A, Berejena C, Terry L, et al. Cotrimoxazole reduces systemic inflammation in HIV infection by altering the gut microbiome and immune activation. Sci Transl Med. 2019;11(486): eaav0537. https://doi.org/10.1126/scitranslmed. aav0537 • Liu B, Li M, Zhou Z, Guan X, Xiang Y. Can we use interleukin-6 (IL-6) blockade for coronavirus disease 2019 (COVID-19)-induced cytokine release syndrome (CRS)? J Autoimmun. 2020; 111:102452. https://doi.org/10.1016/j.jaut.2020.102452 • Vickers IE, Smikle MF. The immunomodulatory effect of antibiotics on the secretion of tumour necrosis factor alpha by peripheral blood mononuclear cells in response to Stenotrophomonas maltophilia stimulation. West Indian Med J. 2006;55(3):138-41. https://doi.org/10.1590/s0043-31442006000300002 • Onyebuagu PC, Kiridi K, Pughikumo DT. Effects of septrin administration on blood cells parameters in humans. Int. J. Basic Appl. Innov. Res, 2014;3(1): 14 -8. https://www.ajol.info/index.php/ijbair/article/view/104688 • Ho JMW, Juurlink DN. Considerations when prescribing trimethoprim– sulfamethoxazole. CMAJ. 2011; 183(16):1851-8. https://doi.org/10.1503/cmaj.111152 • Mahan CS, Walusimbi M, Johnson DF, Lancioni C, Charlebois E, Baseke J, et al. Tuberculosis treatment in HIV infected Ugandans with CD4 counts .350 cells/mm3 reduces immune activation with no effect on HIV load or CD4 count. PLoS one.2010;5(2): e9138. https://doi.org/10.1371/journal.pone.0009138 • Varney VA, Smith B, Quirke G, Parnell H, Ratnatheepan S, Bansal AS, et al. P49 the effects of oral cotrimoxazole upon neutrophil and monocyte activation in patients with pulmonary fibrosis and healthy controls; does this relate to its action in idiopathic pulmonary fibrosis. Thorax. 2017;72: A109. http://dx.doi.org/10.1136/thoraxjnl-2017-210983.191
Omkar Kalidasrao Choudhari, Sonam Spalgis, Umesh Chandra Ojha