Given the extreme importance of the current pandemic caused by COVID-19, and as scientists agree there is no identified pharmacological treatment, where possible, therapeutic alternatives are raised through drug repositioning. This paper presents a selection of studies involving drugs from different pharmaceutical classes with activity against SARS-CoV-2 and SARS-CoV, with the potential for use in the treatment of COVID-19 disease.

Background: The worldwide increase in the occurrence of cancer associated with the limitations of immunotherapy and the emergence of resistance have impaired the prognosis of cancer patients, which leads to the search for alternative treatment methods. Drug repositioning, a well-established process approved by regulatory agencies, is considered an alternative strategy for the fast identification of drugs, because it is relatively less costly and represents lower risks for patients. Areas of Uncertainty: We report the most relevant studies about drug repositioning in oncology, emphasizing that its implementation faces financial and regulatory obstacles, making the creation of incentives necessary to stimulate the involvement of the pharmaceutical industry. Data Sources: We present 63 studies in which 52 non-anticancer drugs with anticancer activity against a number of malignancies are described. Therapeutic Innovations: Some have already been the target of phase III studies, such as the Add-Aspirin trial for nonmetastatic solid tumors, as well as 9 other drugs (aprepitant, artesunate, auranofin, captopril, celecoxib, disulfiram, itraconazole, ritonavir, and sertraline) in the CUSP9* clinical trial for the treatment of recurrent glioblastoma. Others have already been successful in repositioning such as thalidomide, zoledronic acid, celecoxib, methotrexate, and gemcitabine. Conclusions: Therefore, drug repositioning represents a promising alternative for the treatment of oncological disorders; however, the support from funding agencies and from the government is still needed, the latter regarding regulatory issues.

Purpose The absence of specific treatments for COVID-19 leads to an intense global effort in the search for new therapeutic interventions and better clinical outcomes for patients. This review aimed to present a selection of accepted studies that reported the activity of antidepressant drugs belonging to the selective serotonin receptor inhibitor (SSRI) class for treating the novel coronavirus. Methods A search was performed in PubMed and SciELO databases using the following search strategies: [(coronavirus) OR (COVID) OR (SARS-CoV-2) AND (antidepressant) OR (serotonin) OR (selective serotonin receptor inhibitors)]. In the end, eleven articles were included. We also covered information obtained from ClinicalTrials.gov in our research. Results Although several clinical trials are ongoing, only a few drugs have been officially approved to treat the infection. Remdesivir, an antiviral drug, despite favorable preliminary results, has restricted the use due to the risk of toxicity and methodological flaws. Antidepressant drugs were able to reduce the risk of intubation or death related to COVID-19, decrease the need for intensive medical care, and severely inhibit viral titers by up to 99%. Among the SSRIs studied so far, fluoxetine and fluvoxamine have shown to be the most promising against SARS-CoV-2. Conclusion If successful, these drugs can substantially reduce hospitalization and mortality rates, as well as allow for fully outpatient treatment for mild-to-moderate infections. Thus, repositioning SSRIs can provide benefits when faced with a rapidly evolving pandemic such as COVID-19.

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Objetivo: Avaliar o perfil etiológico e de resistência aos antimicrobianos das hemoculturas realizadas em um hospital universitário. Métodos: Analisaram-se retrospectivamente as hemoculturas positivas realizadas no hospital durante janeiro a dezembro de 2018. Foram coletadas informações referentes ao gênero e faixa etária, tipo de coleta (periférica/cateter), setores de internação hospitalar, microrganismos envolvidos, tempo de positividade médio (TPM) e perfil de resistência aos agentes antimicrobianos. Resultados: Das 870 hemoculturas positivas, houve preponderância no gênero masculino (53,0%), em adultos (33,9%), no sangue periférico (65,7%) e no setor de Pronto Atendimento Adulto (23,4%). Staphylococcus epidermidis (38,1%) e Klebsiella pneumoniae (26,3%) foram os microrganismos prevalentes. O TPM das bactérias foi inferior a 24 horas (18h 39min e 17h, Gram positivas e Gram negativas, respectivamente), e para fungos (4,7 % do total), acima de 48 horas (52h 26min). Staphylococcus apresentou resistência significativa frente à oxacilina (S. epidermidis - 82,3% e S. hominis - 85,5%). A resistência de K. pneumoniae frente aos carbapenêmicos foi de 56,5%, à colistina de 23,2% e às cefalosporinas de 53,6%. Conclusões: A resistência a oxacilina nos estafilococos coagulase, bem como a dos carbapenêmicos, colistina e cefalosporinas de amplo espectro em K. pneumoniae são fatores preocupantes. A infecção de corrente sanguínea, mesmo em países desenvolvidos, constitui, ainda, importante fonte de mortalidade. A imediata antibioticoterapia correta impacta financeiramente e no desfecho clínico. Estudos epidemiológicos como este ofertam importantes subsídios, colaborando com o início da terapia efetiva e o aumento significativo da probabilidade de sobrevivência do paciente.

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Bacterial resistance has propelled one of the most serious public health problems in the world. In this sense, drug repurposing has emerged for faster identification of effective drugs. The aim of this study was to investigate the repurposing of escitalopram oxalate and clonazepam drugs individually and in combination with antibiotics ciprofloxacin and sulfamethoxazole-trimethoprim to treat multidrug-resistant microorganisms (MDR) and to evaluate the chemical nuclease capacity. The minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), fractional inhibitory concentration index (FICI) and tolerance level were determined against each microorganism tested. In vitro antibacterial activity was evaluated against forty-seven multidrug-resistant clinical isolates and eleven standard bacterial strains of the American Type Culture Collection (ATCC). Escitalopram oxalate was active mainly against Gram-positive and clonazepam against Gram-positive and Gram-negative bacteria. When associated with the two antibiotics mentioned, they had a significant synergistic effect. Clonazepam was able to cleave plasmid DNA and the mechanisms involved were oxidative and hydrolytic. These results allow us to suggest repurposing these non-antibiotic drugs to treat bacterial infections. However, further studies on the mechanism of action of these drugs should be performed, including to increase safety in use.