20-Week Study of Clinical Outcomes of Over-the-Counter COVID-19 Prophylaxis and Treatment

Objectives and Setting.

As the lethal COVID-19 pandemic enters its second year, the need for effective modalities of alleviation remains urgent. This includes modalities that can readily be used by the public to reduce disease spread and severity. Such preventive measures and early-stage treatments may temper the immediacy of demand for advanced anti-COVID measures (drugs, antibodies, vaccines) and help relieve strain also on other health system resources.

Design and Participants.

We present results of a clinical study with a multi-component OTC “core formulation” regimen used in a multiply exposed adult population. Analysis of clinical outcome data from our sample of over 100 subjects − comprised of roughly equal sized regimen-compliant (test) and non-compliant (control) groups meeting equivalent inclusion criteria − demonstrates a strong statistical significance in favor of use of the core formulations.

Results.

While both groups were moderate in size, the difference between them in outcomes over the 20-week study period was large and stark: Just under 4% of the compliant test group presented flu-like symptoms, but none of the test group was COVID-positive; whereas 20% of the non-compliant control group presented flu-like symptoms, three-quarters of whom (15% overall of the control group) were COVID-positive.

Conclusions.

Offering a low cost, readily implemented anti-viral approach, the study regimen may serve, at the least, as a stopgap modality and, perhaps, as a useful tool in combatting the pandemic.

A trial of the use of bar code technology to restructure a drug distribution and administration system

As we move into the 1990s, the challenges we face are many. Our ever-changing health care industry is giving managers, directors, and administrators much to ponder: how do we reduce costs and improve patient care? One promising area that may help answer this question in pharmacy services is bar code technology. This article offers helpful advice about the development of bar code and drug delivery systems and discusses the future applications of bar code technology in pharmacy practice, based on 3 years of hands-on experience at Florida Medical Center.

Changing prescribing patterns: a program of physician education

A drug utilization review identified significant inappropriate use of second-generation cephalosporins at a 700-bed community teaching hospital. As a result, an educational program designed to modify physician prescribing patterns was developed as a cost-containment measure. Educational guidelines listing indications and contraindications for cefamandole and cefoxitin and comparing their costs with those of first-generation cephalosporins were placed in patient records, and physician use of these agents was reviewed before, during, and after the intervention. The rate of combined appropriate use of cefamandole and cefoxitin increased from 30 to 58% during the study. A change from the second-generation cephalosporins to therapeutically equivalent, less-expensive drugs was noted in 28% of patients' medical records within 48 hours after placement of the guidelines. This educational program proved to be a low-cost method of successfully altering the prescribing patterns of physicians.

Ethanol, disulfiram, and pyrazole: effects on interferon production in mice

The effects of ethanol alone or combined with pyrazole or disulfiram were studied in reference to interferon production. Saline, ethanol (2 g/kg), pyrazole (2 mg/kg), or disulfiram (2 mg/kg) were injected, intraperitoneally, 3 hr after poly I:C, an interferon inducer. Drugs were administered either by a single injection, or twice daily for 7 days, and the mice were sacrificed 6 hr after poly I:C. Sera from mice were pooled, dialyzed, and assayed for interferon by the microplaque reduction method. Administration of ethanol alone reduced interferon production 76% and 66% after the single and the multiple injections, respectively. A similar inhibition of interferon occurred after either pyrazole or disulfiram, with a greater potency for pyrazole. Treatment with pyrazole prior to ethanol reduced interferon production further, but only after the 7-day schedule. All drugs tested affected cellular immunity as measured by interferon production. Moreover, reduced interferon production by these agents was associated with a loss of splenic lymphoid tissue, suggesting that ethanol, pyrazole, and disulfiram could affect susceptibility to viral infection.