The increasing prevalence of hospital- and community-acquired infections caused by multidrug-resistant bacterial pathogens is limiting the options for effective antibiotic therapy. Moreover, this alarming spread of antimicrobial resistance has not been paralleled by the development of novel antimicrobials. Resistance to the scarce new antibiotics is also emerging. In this context, the rational use of older antibiotics could represent an alternative for the treatment of multidrug-resistant bacterial pathogens. This strategy would help to optimize the armamentarium of antibiotics so as to preserve the effectiveness of new antibiotics and avoid the prescription of drugs known to favor the spread of resistance (i.e., quinolones). Furthermore, from a global economic perspective, this strategy could be useful in public health, given that several of these cheapest “forgotten” antibiotics are not available in many countries. We will review here the successful treatment of multidrug-resistant bacterial infections with old antibiotics and discuss their place in current practice.

Describe and evaluate the outcome of a coronavirus disease-2019 (COVID-19) patient without shortness of breath. We retrospectively collected data from COVID-19 patients diagnosed and cared for in Marseille, France. We selected data from patients who at admission, had a low dose CT scanner, dyspnea status, and oxygen saturation available. Blood gas was analyzed in a sample subset of patients. Among 1712 patients with COVID-19, we report that 1107 (64.7%) do not complain of shortness of breath at admission. The low-dose computed tomography (LDCT) scan showed signs compatible with pneumonia in 757/1,107 (68.4%) of patients without dyspnea. In a subset of patients who had underwent at least one blood gas analysis (n = 161) and presented without dyspnea at admission, 28.1% (27/96) presented with a hypoxemia/hypocapnia syndrome. Asymptomatic hypoxia was associated with a very poor outcome (33.3% were transferred to the ICU and 25.9% died). The absence of shortness of breath in an old patient with comorbidity merit medical attention and should not be considered as a good sign of well-being. The poor prognosis of asymptomatic hypoxia, highlight the severity of this mild clinical presentation. In these patients, pulse oximetry is an important mean to predict the outcome along with news score and LDCT scanner.

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According to some studies, ascorbic acid possesses antiviral properties. These studies were mainly focused on the common cold, with very few focusing on other viral infections.