Bismuth Subsalicylate For Covid-19 Pneumonia?

Bismuth subsalicylate is readily available over-the-counter in the U.S. as Pepto Bismol, and in many other countries. It’s OTC here because it’s a very safe drug.

Frontiers in Drug Discovery published and article by U.S. authors suggesting a benefit for the use of oral bismuth subsalycilate for hospitalized patients with Covid-19 pneumonia. The benefit was a “marked improvement in oxygen requirements in most of the cases.” In other words, patients needed a lower amount of supplemental oxygen delivered to the lungs. That means lung function is improving.

This was a tiny study, only eight patients, and they were all pretty sick, as I recall. Most of them got dexamethasone, remdesivir, and either tocilizumab or baricitunib. To get into the study, they needed loose stools or diarrhea and at least five days of high oxygen requirements. (As an aside, I’ve notice many hospitalized COVID patients have heartburn, and in the final third of the pandemic to this point, diarrhea is often prominent.)

The biggest problems with the study are the lack of a control group and the small sample size. The authors admit this was just an exploratory study and call for a more thorough investigation. Who’s going to pay for that? Procter & Gamble, the distributors of Pepto Bismol? It sure as hell won’t be the makers of the vaccines, remdesivir, tocilizumab, or baricitunib

Steve Parker, M.D.

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