Chloroquine In Prophylaxis Research Articles

Drugs, Metabolites, and Lung Accumulating Small Lysosomotropic Molecules: Multiple Targeting Impedes SARS-CoV-2 Infection and Progress to COVID-19

Lysosomotropism is a biological characteristic of small molecules, independently present of their intrinsic pharmacological effects. Lysosomotropic compounds, in general, affect various targets, such as lipid second messengers originating from lysosomal enzymes promoting endothelial stress response in systemic inflammation; inflammatory messengers, such as IL-6; and cathepsin L-dependent viral entry into host cells. This heterogeneous group of drugs and active metabolites comprise various promising candidates with more favorable drug profiles than initially considered (hydroxy) chloroquine in prophylaxis and treatment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections/Coronavirus disease 2019 (COVID-19) and cytokine release syndrome (CRS) triggered by bacterial or viral infections. In this hypothesis, we discuss the possible relationships among lysosomotropism, enrichment in lysosomes of pulmonary tissue, SARS-CoV-2 infection, and transition to COVID-19. Moreover, we deduce further suitable approved drugs and active metabolites based with a more favorable drug profile on rational eligibility criteria, including readily available over-the-counter (OTC) drugs. Benefits to patients already receiving lysosomotropic drugs for other pre-existing conditions underline their vital clinical relevance in the current SARS-CoV2/COVID-19 pandemic.

Hydroxychloroquine and Chloroquine in Prophylaxis and Treatment of COVID-19: What Is Known?

ABSTRACTThe corona virus disease-19 (COVID-19) pandemic has affected the entire world causing huge economic losses and considerable morbidity and mortality. Considering the explosive growth of the pandemic repurposing existing medicines may be cost-effective and may be approved for use in COVID-19 faster. Researchers and medical practitioners worldwide have explored the use of chloroquine and hydroxychloroquine, in few occasions combined with the macrolide antibiotic azithromycin, for COVID-19 treatment. These two drugs are economic and easily available, and hence gained attention as a potential option for COVID-19 management. As per the available evidence, the outcomes of treatments with these medications are conflicting from both the efficacy and safety (predominantly cardiac related) perspectives. Currently, multiple studies are underway to test the safety and efficacy of these medications and more results are expected in the near future. The retina, the endocrine system (with risk of hypoglycemia), the musculoskeletal system, the hematological system, and the neurological system may also be affected. The use of these drugs is contraindicated in patients with arrhythmias, known hypersensitivity, and in patients on amiodarone. In addition to the published literature, personal communication with doctors treating COVID-19 patients seems to suggest the drugs may be effective in reducing symptoms and hastening clinical recovery. The literature evidence is still equivocal and further results are awaited. There has been recent controversy including retraction of articles published in prestigious journals about these medicines. Their low cost, long history of use, and easy availability are positive factors with regard to use of these drugs in COVID-19.

Role of hydroxychloroquine and chloroquine in prophylaxis against COVID19 review study

The ongoing coronavirus pandemic has pushed that global healthcare system in crises and led to huge losses in terms of life and property. Different drugs for prophylaxis against COVID-19 including Chloroquine (CQ) or Hydroxychloroquine (HCQ) have been tried. This study was performed to systematically review the role of CQ and HCQ in the prophylaxis of COVID-19. Various databases like PubMed, EMBASE, ClinicalTrials.gov, International Clinical Trials Registry Platform and Cochrane Library databases were searched for studies that evaluated the prophylactic role of CQ or HCQ on SARS-CoV-2 (pre-clinical studies) or COVID-19 (clinical studies) until 6th May 2020. The available literature was critically appraised. A total of 36 articles were screened and 4 in vitro pre-clinical studies and 2 clinical opines, 4 clinical studies and promising clinical trials registered at clinicaltrials.gov were included in analysis. The pre-clinical studies showed the prophylactic effects of CQ and HCQ against SARS-CoV-2. On the other hand, the clinical opinions advocated the prophylactic use of CQ and HCQ against COVID-19. However, no original clinical studies on the prophylactic role of CQ or HCQ on COVID-19 were available. Although Preclinical trials and in vitro studies support the use of CQ and HCQ in prophylaxis against COVID19, there is a dearth of concrete clinical data to support the same. However, in a resource poor country the benefits of chemoprophylaxis will augment the safety of Frontline workers against COVID19. Long term follow up studies and high quality randomised controlled studies are required to establish the fact more prudently.

Role of hydroxychloroquine and chloroquine in prophylaxis against COVID19 review study

Role of hydroxychloroquine and chloroquine in prophylaxis against COVID19 review study

Malaria, Mefloquine, Madness, and Mosquito Nets-Reply

In Reply. — Choosing a drug for prophylaxis against malaria requires weighing the risk of malaria infection against the effectiveness and tolerance of the drug. Mefloquine is the most effective drug available to prevent infections with chloroquine-resistant Plasmodium falciparum malaria, a potentially fatal infection. Available data indicate that the drug is well tolerated when used for prophylaxis at doses of 250 mg. The frequency and type of mild or moderate adverse events reported by users of mefloquine for prophylaxis do not differ from those reported by users of chloroquine for prophylaxis. 1,2 Anecdotal case reports suggest that serious neurological and psychiatric events, such as convulsions or hallucinations, are possible with mefloquine for prophylaxis; however, such events have not been reported from prophylactic drug trials or from surveys of users of mefloquine for prophylaxis. 1-4 These studies included a total of 18 591 persons. 2 In contrast, therapeutic doses of mefloquine,

Efficacy of malaria prophylaxis in American and Swiss travelers to Kenya.

The protective effect of malaria chemoprophylaxis with either Fansidar (pyrimethamine-sulfadoxine) or chloroquine was estimated by determining the attack rates of Plasmodium falciparum infections acquired in Kenya and imported by U.S. and Swiss travelers who had used no chemoprophylaxis, who had used only chloroquine for prophylaxis, and who had used Fansidar weekly, either alone or in combination with chloroquine. The estimated attack rates were almost identical in U.S. and Swiss travelers. The attack rate per 100,000 travelers averaged 280 in those who did not use chemoprophylaxis, 162 in those who took 4-aminoquinolines (P greater than .05), and 27 in those who used Fansidar for prophylaxis (P less than .001). Non-immune travelers to Kenya have an appreciable risk of acquiring a P. falciparum infection and need to be informed of current guidelines for chemoprophylaxis. The changing drug susceptibility patterns in Africa require continuous evaluation of the efficacy of recommended drug regimens for malaria prophylaxis.