The Role of High Dose Co-trimoxazole in Severe Covid-19 Patients
COVID-19 Pneumonia
About this trial
This is an interventional treatment trial for COVID-19 Pneumonia focused on measuring COVID-19, Co-trimoxazole, RCT
Eligibility Criteria
Inclusion criteria
- Confirmed COVID-19 patients by RT-PCR
- Clinically suspected COVID-19 patients
- Age > 18 years
- Patients requiring oxygen at least> 5L/min up to 15 L/min (by FM/ NRM)to maintain saturation >92% to 96%
NOTE: Clinically suspected COVID-19 = fever (Temperature >37.8 Degree Celsius) + respiratory symptoms + Radiological evidences Exclusion criteria
- Multi-organ failure
- Severe ARDS (requiring HFNC orventilatory support on presentation in the form ofinvasive or non-invasive ventilation)
- Septic Shock
- Severe liver disease
- Acute Heart Failure
- Acute Kidney Injury (where GFR< 15 and plasma-sulfamethoxazoleconcentration cannot be monitored)
- Drug allergy/intolerance to co-trimoxazole / Sulphar sensitivity
- Pregnancy
Sites / Locations
- Bangabandhu Sheikh Mujib Medical University
Arms of the Study
Arm 1
Arm 2
Experimental
Placebo Comparator
Intervention
Standard
Eligible patients will be receiving either to oral co-trimoxazole + standard therapy. Tab. Co-trimoxazole 960 mg (trimethoprim 160mg + sulphamethoxazole 800mg) thrice (8 hourly) daily for 7 days orally. The following treatments are recommended as standard therapy: Antibiotics for secondary bacterial infection as per institutional guidelines Supplemental oxygen (to keep saturations between 92% to 96%) Intravenous hydration (to maintain euvolumia) Thrombo-prophylaxis as per local guidelines Paracetamol (oral or I/V 1gram QDS as required or regular) To consider steroids in appropriate cases. Nasopharyngeal and throat swab to be sent for RT PCR to detect SARS-CoV-2 (if not already done) and blood culture Tab. Co-trimoxazole 960 mg (trimethoprim 160mg + sulphamethoxazole 800mg) thrice (8 hourly) daily for 7 days orally.
Standard therapy along with placebo. Placebo thrice (8 hourly) for 7 days. The following treatments are recommended as standard therapy: Antibiotics for secondary bacterial infection as per institutional guidelines Supplemental oxygen (to keep saturations between 92% to 96%) Intravenous hydration (to maintain euvolumia) Thrombo-prophylaxis as per local guidelines Paracetamol (oral or I/V 1gram QDS as required or regular) To consider steroids in appropriate cases. Nasopharyngeal and throat swab to be sent for RT PCR to detect SARS-CoV-2 (if not already done) and blood culture