Did three general practitioners who were talking on a Facebook group find a Covid-19 parade usable on a very large scale? Denis Gastaldi, Jean-Jacques Erbstein and Olivia Vansteenberghe, respectively doctors in Morhange, Créhange (Moselle) and Wormhout (North) prefer to remain very careful, while expressing their great hopes. Dr. Gastaldi assures the Parisian-Today in France that the trio has tested a treatment on several hundred patients in a formidably effective manner. His colleague Dr. Erbstein spoke on Saturday in the East of the Republic, advancing less extensive figures .

Their combination of drugs is based on the research of Professor Raoult , their knowledge of other treatments and a good dose of pragmatism. "It's very empirical," explains Dr. Gastaldi. The three of us discussed the possible treatments. As we could not use hydroxychloroquine in the protocol of Pr Didier Raoult (Editor's note: general practitioners are not authorized to prescribe this molecule), we wondered if azithromycin could not be the basis of treatment. Especially since we realize that hydroxychloroquine is not that miraculous. Azithromycin has the advantage of being an antibiotic, but also of having an action on viruses and an anti-inflammatory activity on the pulmonary parenchyma (Editor's note: the functional tissue of the lungs) . "

And to continue: “We thought about what could increase the effect of this drug. Zinc is very effective for this. Two Effizinc capsules are added to the protocol. Still empirically, Singulair, used in people with asthma, has been added for its role as an anti-inflammatory on interstitial lung tissue. In severe forms, low-dose heparin is added to prevent thrombosis, phlebitis and pulmonary embolism, which is common with coronavirus. One of the sine qua non conditions is to start this treatment at the first symptoms, not to wait until being in intensive care. "

Encouraging results

If the cocktail born from conversations on the Facebook group "Le Divan des Médecins", which lists 13,600 practitioners, may seem difficult to understand for the uninitiated, the results presented by the trio seem encouraging.

"For the past few weeks, the three of us have prescribed this treatment to all of our coronavirus patients," explains Denis Gastaldi. Personally, this represents more than 200 patients. I have had only two serious cases requiring hospitalization which have since been released. Obviously, this is not a multicenter, randomized study, but these are very interesting results. If one relies on known data on the disease, out of at least 200 cases, one should have had at least two deaths and around forty hospitalizations. "

Doctor Gastaldi assures that his patient base is made up of patients of all ages, some with additional risk factors (comorbidities) . Doctor Erbstein, who had to deplore six deaths since the beginning of the epidemic in his patient base, notably made up of former miners, explained in the Republican East: “For fifteen days that I have been experimenting with this formula, I have not had neither death nor hospitalization ”.

Aware of the limits of their approach

In addition to the absence of study mentioned by the practitioner, the trio is perfectly aware of the limits in terms of researching its approach. The cases treated have not been tested positive for Covid-19, contrary to what Professor Raoult is putting in place, and for good reason, patients in city offices do not enter the beneficiaries of the tests defined by the health authorities strategy.

Dr. Gastaldi himself was affected by Covid-19, as confirmed by a serological test which he has carried out since. He self-prescribed his protocol. “I was not well on Friday and on Monday I worked. It may not be due to the treatment, but it is the feedback that almost all the patients to whom I apply: after three days, they tell me that they are fine. "

Unlike hydroxychloroquine, whose cardiac effects are reported , the doctor is reassuring about the protocol tested and hopes that it will develop in the medical community: "Azithromycin is widely prescribed every winter in children and adults , without side effects. There is no reason to deprive yourself of it at the first symptom. It would be great to save lives! "

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A message rather addressed to his fellow practitioners than a candidacy for a Nobel Prize in medicine. "It is not at all our role to enter into a protocol of validation by the authorities, believes the doctor Mosellan. I will tell you, the studies that will give us results in six months, when the epidemic is over, I don't care. What interests me are my patients. Inevitably, this will enter a protocol at some point, coming back to the ears of specialists, but we must be humble. We are in Lorraine, in Moselle, in the North, we are trying to do our job as best as possible, so that there are as few deaths as possible. "