Remote prescribing of antibiotics for suspect chest infection is becoming more common in times of Covid19 pandemic. There is some evidence that clarithromycin may inhibit seasonal human influenza virus infection by reducing SAalpha2,6Gal partly through the inhibition of NF-kappaB, and increasing pH in endosomes in airway epithelial cells. Clarithromycin may modulate airway inflammation in influenza virus infection. Increasing pH in endosomes in airway epithelial cells may have a positive impact also when dealing with SARS-CoV-2. I therefore wonder if this antibiotic should be preferred to amoxicillin in this phase of the pandemic, particularly in absence of testing, or alternative available treatments (including anti-malaria drugs). Among 6 patients within my pool, only one was on clarithromycin, this being prescribed remotely (positive final outcome).
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