200 mg of Hydroxychloroquine orally three times daily for 10 days plus 500 mg of Nitazoxanide orally twice daily for 6 days

Standard care delivered in the COVID-19 isolation hospitals.

COVID-19

Both hydroxychloroquine & nitazoxanide will be administered orally to participating patients

Hydroxychloroquine plus Nitazoxanide

Oxygen administered via ventilator. In addition, antipyretic "paracetamol" may be added if necessary

Standard care

Hydroxychloroquine and Nitazoxanide Combination Therapy for COVID-19

Clinical Trial Evaluating Safety and Efficacy of Hydroxychloroquine and Nitazoxanide Combination as Adjuvant Therapy in Covid-19 Newly Diagnosed Egyptian Patients: A Tanta University Hope

improved breaths per minute for the patients

Serum iron in microgram/dL of the patients

Serum ferritinin microgram/L of the patients

International normalized ratio "INR" for prothrombin time of 2

CBC for lymphocyte count in cells/microliter

Mortality rate [number of dead patients/total number of treated patients]

Prof. Dr. Kamal Mohammed Okasha

Vice-President of Postgraduate Studies and Research Affairs

Tanta University

a double blind randomized controlled parallel study

The patient will received a combination of 3 antibiotics :
Rifampicin (10mg/kg once daily)
Ethambutol (15 to 20 mg/kg once daily)
Clarithromycin (500 mg twice daily)

The patient will received a combination of 3 antibiotics :
Rifampicin (10mg/kg once daily)
Ethambutol (15 to 20 mg/kg once daily)
Azithromycin (250 mg once daily)

Lung Infection

Mycobacterium Avium Complex

The patient will be received for at least 12 months, a daily antibiotic treatment who is a combination of Clarithromycin, Ethambutol and Rifampicin.

Clarithromycin 1000 MG

The patient will be received for at least 12 months, a daily antibiotic treatment who is a combination of Azithromycin, Ethambutol and Rifampicin.

Azithromycin 250 mg

The patient will be received for at least 12 months, a dailty antibiotic treatment who is a combination of Azithromycin or Clarithromycin (according to the randomisation), Ethambutol and Rifampicin.

Rifampicin

Ethambutol

CHU Amiens Picardie

Saint Joseph Hospital

CLArithromycin Versus AZIthromycin in the Treatment of Mycobacterium Avium Complex (MAC) Lung Infections

Three spontaneous sputum specimens will be obtained at baseline and 6 months. If it's not possible to obtain good quality specimens, the clinician may perform three hypertonic aerosol-induced sputum specimens on 3 consecutive days. In the absence of sputum (spontaneous or induced), bronchoscopic aspiration and two post-bronchoscopy sputum specimens will be performed.
Microscopic examination will be performed after auramine or Ziehl-Neelsen stain.
Specimens will be cultured at 37°C after decontamination on Lowenstein-Jensen solid medium and Coletsos medium. Results will be expressed quantitatively as the number of colonies per tube according to a logarithmic scale. Culture on liquid medium will also be performed.
The analysis will be based on the Mycobacteria National Reference Centre microscopy, culture and antibiotic susceptibility test results.

Several criteria will be determined at baseline and at 3 months and then compared to assess clinical improvement :
Presence or absence of cough, sputum, dyspnoea, chest pain and wheezing using a 5-point analogue scale (0=no symptom, 4=permanent symptoms) ;
WHO performance status scored from 0 to 4 ;
Global score from 0 to 24, taking into account the score of the 5 respiratory symptoms and the WHO performance status ;
Presence of blood-stained sputum (haemoptysis greater than 50 mL or requiring specialized medical intervention)
Weight in kg (patient weighed in underwear on the same scales, variations taken into account when greater than 5% of the baseline weight).

Several criteria will be determined at baseline and at 6 months and then compared to assess clinical improvement :
Presence or absence of cough, sputum, dyspnoea, chest pain and wheezing using a 5-point analogue scale (0=no symptom, 4=permanent symptoms) ;
WHO performance status scored from 0 to 4 ;
Global score from 0 to 24, taking into account the score of the 5 respiratory symptoms and the WHO performance status ;
Presence of blood-stained sputum (haemoptysis greater than 50 mL or requiring specialized medical intervention)
Weight in kg (patient weighed in underwear on the same scales, variations taken into account when greater than 5% of the baseline weight).

Several criteria will be determined at baseline and at 12 months and then compared to assess clinical improvement :
Presence or absence of cough, sputum, dyspnoea, chest pain and wheezing using a 5-point analogue scale (0=no symptom, 4=permanent symptoms) ;
WHO performance status scored from 0 to 4 ;
Global score from 0 to 24, taking into account the score of the 5 respiratory symptoms and the WHO performance status ;
Presence of blood-stained sputum (haemoptysis greater than 50 mL or requiring specialized medical intervention)
Weight in kg (patient weighed in underwear on the same scales, variations taken into account when greater than 5% of the baseline weight).

Chest x-ray will be realised at baseline and at 3 months and described according to :
type of lesion: opacity/solitary pulmonary nodule, excavated opacity/ fibrocavitary disease, interstitial syndrome (multiple nodule, dense airspace disease)
precise site (upper lobe, right middle or lower lobe, left lower or upper lobe)

Chest x-ray and chest high-resolution CT will be realised at baseline and at 6 months.
Chest x-ray will be described according to:
type of lesion: opacity/solitary pulmonary nodule, excavated opacity/ fibrocavitary disease, interstitial syndrome (multiple nodule, dense airspace disease)
precise site (upper lobe, right middle or lower lobe, left lower or upper lobe)
Chest CT will be described according to:
type of lesion: nodules, micronodules, bronchiectasis, mass, interstitial syndrome (and its type)
precise site of the segment(s) involved
number of lesions
dimensions of the various lesions (long and short axes) and volume, whenever possible.

Chest x-ray and chest high-resolution CT will be realised at baseline and at 12 months.
Chest x-ray will be described according to:
type of lesion: opacity/solitary pulmonary nodule, excavated opacity/ fibrocavitary disease, interstitial syndrome (multiple nodule, dense airspace disease)
precise site (upper lobe, right middle or lower lobe, left lower or upper lobe)
Chest CT will be described according to:
type of lesion: nodules, micronodules, bronchiectasis, mass, interstitial syndrome (and its type)
precise site of the segment(s) involved
number of lesions
dimensions of the various lesions (long and short axes) and volume, whenever possible.

Microbiological specimens, preferably 3 sputum specimens, will be obtained and processed at 3 months after treatment according to the same modalities as at baseline.

Microbiological specimens, preferably 3 sputum specimens, will be obtained and processed at 12 months after treatment according to the same modalities as at baseline.

The 12-month mortality will be determined by the survival at that date. The date of any death occurring during treatment will be recorded and the interval between the start of treatment and death will be calculated. The cause of death will be investigated and reported.

All adverse events will be notified according to the recommendations. Particular attention will be paid to gastrointestinal adverse effects (the incidence of nausea and vomiting will be recorded). These adverse events will be assessed at each visit according to the Rhodes scale.
Haematological, gastrointestinal and renal toxicities will be scored according to the WHO toxicity scale.

Centre Hospitalier Universitaire, Amiens

Diet modification - nortriptyline and then if necessary topiramate

Diet Modification topiramate and then nortriptyline if necessary

Migraine Disorders

The nortriptyline will be given in an escalating fashion, starting at 25 mg PO qhs for 2 weeks, followed by 50 mg PO qhs for 2 weeks, and finally 75 mg PO qhs. Patients will be encouraged to use the lowest effective dose and to self-titrate their medication.

nortriptyline

Topiramate dosing will be 25 mg PO qhs for 1 week, followed by 25 mg BID for 1 week, followed by 25 mg in the morning and 50 mg qhs for 1 week, and finally 50 mg BID

Topiramate

Saint Louis University

Trial of Nortriptyline and Topiramate in the Initial Treatment of Vestibular Migraine

A Prospective Randomized Cross-over Trial of Nortryptyline and Topiramate in the Initial Treatment of Vestibular Migraine.

Changes in Migraine Specific Quality of LIfe (MSQ) and Dizziness Handicap Inventory (DHI) between groups

digoxin/i̇shal

Hydroxychloroquine and Nitazoxanide Combination Therapy for COVID-19

CLArithromycin Versus AZIthromycin in the Treatment of Mycobacterium Avium Complex (MAC) Lung Infections

Trial of Nortriptyline and Topiramate in the Initial Treatment of Vestibular Migraine

Trial of Mesalamine for the Treatment of Active Microscopic Colitis

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