re: Chloroquine cured this flu in France at 100% success rate

Some people just want to be miserable twats.

She will be in about 18 years if this is the treatment we go to

So azithromycin an antibiotic actually has been shown to reduce viral load in several studies? I always thought antibiotics were useless for viral infections. Googled it and found several older journal articles. Looked it up thinking the antibiotic must be used treat potential bacterial coinfection. So my idiot boss who took a Z pack but insisted he had a virus was correct?!

So much for this

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don't think it's fda approved and it does have potential side effects that are concerning

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Are you sure about that?? Having been used for Malaria treatment, chances are good it is FDA approved.


LINK

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So azithromycin an antibiotic actually has been shown to reduce viral load in several studies? I always thought antibiotics were useless for viral infections.

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Yes on one of the other threads we had a doctor who said azithromyacin is a magical antibiotic (half jokingly). :)

There is a YouTube video of the French doctor who discusses the reasoning for using those drugs.

I have a side question Doc. Any adverse side effects in individuals with TTP?

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Any adverse side effects in individuals with TTP?

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Sorry. Didn't see your question earlier. Sort of posted and ran.


The two meds mentioned (chloroquine and hydroxychloroquine) can both cause (good, old-fashioned) thrombocytopenia. If you search for either drug + "ttp," you'll find a handful of cases where they link TTP to the drug (or try to). So depending on the severity of TTP or if there was a pretty significant thrombocytopenia at the onset of illness, I'd shy away because- and if you check my post history for the post you replied to, I made the same post in that other thread, and in there I said it several times (to the dismay of most as apparently my writing style tends to convey negativity, I am learning. And that's not intentional)- this isn't "the" treatment. The "100%" didn't include a lot of patients. The Marseille study actually still had some patients die and several with comorbidities (unspecified) were excluded from therapy for fear of drug interaction with something they were already taking.

So, I'm long winded. This I know. Sorry. But the best way I could say it and carefully word it would be, "I don't think there's a definite link between TTP and (hydroxy) chloroquine, but they both can cause thrombocytopenia (and pancytopenia), so I would in my practice probably not use it first line, but I don't think that another doctor who knows all of those things would necessarily be wrong for using it, assuming he monitors for symptoms and checks daily labs for the duration of therapy."
As I posted in the other thread (and am just too lazy and not so on top of the data that I can rattle off the other 4-5 experimental treatments) kaletra would be a reasonable thing to try in a critically ill patient. A macrolide may be of benefit (as above). But if a TTP patient had a snotty nose, a fever, and could otherwise go home, I'd probably let them go without an antiviral therapy but just good symptomatic care and frequent contact (as they'd be higher-risk for complications vs their identical twin without TTP)

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No, it’s not. Do you think it makes you sound cool to call it that? Because you sound like a fool.

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By "it", are you referring to the flu like virus from wuhan china?

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Which the FDA came out after the presser to let everyone know that it is NOT FDA approved.

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Well, it is FDA approved for certain things.
It doesn't have the FDA stamp of approval for viral infections. I watched Trump speak. I think whomever wrote his words understood what they wrote, but I think he went back and summarized the statement he had just read and sort of jumbled it, leading to some confusion.

It's an important distinction. If the medication had no FDA approval, it would be difficult for a doctor to write it, even now (compassionate use and right to try exist, but they're not common and almost never impactful on the scale that we are talking about with the current pandemic)
But it IS approved for certain things. Fortunately, healthcare is set up in such a way that a medical license basically entitles a doctor to say, "well, it's approved for this, but I could use it for this." Or "well, this is the dose that was studied. Based on the data, I think it's safe to actually use THIS dose (either higher or lower)." I do this a lot. The first example that comes to mind is Trazodone. Trazodone is FDA approved for the treatment of major depression. It has never gotten an FDA indication for insomnia. I write it for insomnia all the time, because in this country, doctors aren't prevented from using what's available, though they do open themselves up to liability by doing so, should they be totally cowboy and, say, use insulin to treat an ingrown toenail. As I've said a few times before, lack of FDA indication does not prevent a therapy from becoming the standard of care.


Because of that, people should realize a few important things:
1) there's a bit of evidence this drug may work fairly well and curb the outcomes leading to fewer cases and deaths. Not a ton
2) the FDA requires a hell of a lot more info than what is available to say that it does 1
3) doctors get to choose whether they think the evidence in 1 is compelling enough. Some jump on the newest thing before it's proven. Some will be the last to change their old habits regardless of how good data can be. I, personally, like to know and keep up with the newest stuff, but I'm almost never the first one to try it. I'm also almost never the last. My career hasn't been long, but a mentor shared that approach with me, and I do think it's generally best. Kinks get worked out. Almost every "wonderdrug" eventually had some significant downfalls.
4) when a doctor uses something that isn't for labeled use, the patient may be on the hook for the cost of the medicine. In this case it's cheap enough that it's nearly irrelevant. There's a big process where the doctor can send information to the insurance company and beg for coverage. This ends one of two ways. I get someone with a high school education who reads a script and is incapable of helping, or a reasonable physician who just needed another physician (me) to jump through the hoops to save the insurance company some money since most of us are not going through the trouble of waiting on hold for 15-45 minutes during those precious 9-5 weekday hours.