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10.1186/s13063-020-04593-8

http://scihub22266oqcxt.onion/10.1186/s13063-020-04593-8
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32807209!7429453!32807209
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suck abstract from ncbi


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pmid32807209      Trials 2020 ; 21 (1): 718
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  • A multi-centre open-label two-arm randomised superiority clinical trial of azithromycin versus usual care in ambulatory COVID-19: study protocol for the ATOMIC2 trial #MMPMID32807209
  • Hinks TSC; Barber VS; Black J; Dutton SJ; Jabeen M; Melhorn J; Rahman NM; Richards D; Lasserson D; Pavord ID; Bafadhel M
  • Trials 2020[Aug]; 21 (1): 718 PMID32807209show ga
  • BACKGROUND: Azithromycin is an orally active synthetic macrolide antibiotic with a wide range of anti-bacterial, anti-inflammatory and antiviral properties. It is a safe, inexpensive, generic licenced drug available worldwide and manufactured to scale and is a potential candidate therapy for pandemic coronavirus disease 2019 (COVID-19). Azithromycin was widely used to treat severe SARS-CoV and MERS-CoV, but to date, no randomised data are available in any coronavirus infections. Other ongoing trials are exploring short courses of azithromycin either in early disease, within the first 7 days of symptoms, when azithromycin's antiviral properties may be important, or late in disease when anti-bacterial properties may reduce the risk of secondary bacterial infection. However, the molecule's anti-inflammatory properties, including suppression of pulmonary macrophage-derived pro-inflammatory cytokines such as interleukins-1beta, -6, -8, and -18 and cytokines G-CSF and GM-CSF may provide a distinct therapeutic benefit if given in as a prolonged course during the period of progression from moderate to severe disease. METHODS: ATOMIC2 is a phase II/III, multi-centre, prospective, open-label, two-arm randomised superiority clinical trial of azithromycin versus standard care for adults presenting to hospital with COVID-19 symptoms who are not admitted at initial presentation. We will enrol adults, >/= 18 years of age assessed in acute hospitals in the UK with clinical diagnosis of COVID-19 infection where management on an ambulatory care pathway is deemed appropriate. Participants will be randomised in a 1:1 ratio to usual care or to azithromycin 500 mg orally daily for 14 days with telephone follow-up at days 14 and 28. The primary objective is to compare the proportion with either death or respiratory failure requiring invasive or non-invasive mechanical ventilation over 28 days from randomisation. Secondary objectives include mortality/respiratory failure in those with a PCR-confirmed diagnosis; all-cause mortality; progression to pneumonia; progression to severe pneumonia; peak severity of illness and mechanistic analysis of blood and nasal biomarkers. DISCUSSION: This trial will determine the clinical utility of azithromycin in patients with moderately severe, clinically diagnosed COVID-19 and could be rapidly applicable worldwide. TRIAL REGISTRATION: ClinicalTrials.gov NCT04381962 . Registered on 11 May 2020. EudraCT identifier 2020-001740-26 . Opened for accrual on 29 May 2020.
  • |*Anti-Bacterial Agents/therapeutic use[MESH]
  • |*Azithromycin/therapeutic use[MESH]
  • |*COVID-19 Drug Treatment[MESH]
  • |*COVID-19/diagnosis[MESH]
  • |Ambulatory Care/methods[MESH]
  • |Clinical Trials, Phase II as Topic[MESH]
  • |Clinical Trials, Phase III as Topic[MESH]
  • |Humans[MESH]
  • |Multicenter Studies as Topic[MESH]
  • |Prospective Studies[MESH]
  • |Randomized Controlled Trials as Topic[MESH]
  • |Research Design[MESH]
  • |SARS-CoV-2[MESH]


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