Dec 21, 2021 · Hydroxychloroquine. The drug hydroxychloroquine received a lot of attention at the beginning of the pandemic as a possible way to treat COVID-19. At one time used as an anti-malarial drug, it’s ... Examples include ceftriaxone (Rocephin), piperacillin-tazobactam, cefepime (Maxipime ), ceftazidime (Fortaz) , vancomycin (Firvanq) , ciprofloxacin (Cipro), and levofloxacin (Levaquin). If you ...f The use of another COVID-19 therapy may need to be considered. These immunosuppressants have significant drug-drug interaction potential with ritonavir, and they should not be used if close monitoring, including therapeutic drug monitoring (i.e., measuring drug concentration), is not feasible. Consult a patient’s specialist providers before ...casirivimab and imdevimab, which must be administered together. the oral medication baricitinib (Olumiant), which must be administered with remdesivir. COVID-19 convalescent plasma. Fresenius Kabi ...Mar 20, 2020 · SARS-CoV-2 – the coronavirus that causes the disease COVID-19 – is completely new and attacks cells in a novel way. Every virus is different and so are the drugs used to treat them. The dosage is based on your medical condition and response to treatment. For the best effect, take this antibiotic at evenly spaced times. To help you remember, take this medication at the same ... The most common symptoms of COVID-19 are a fever, coughing, and breathing problems. Unless you have severe symptoms, you can most likely treat them at home, the way you would for a cold or the flu ...May 1, 2023 · Amoxicillin and clavulanate combination is used to treat bacterial infections in many different parts of the body (eg, ear, lungs, sinus, skin, urinary tract). Amoxicillin and clavulanate combination is an antibiotic that belongs to the group of medicines known as penicillins and beta-lactamase inhibitors. Diarrhea, nausea, or vomiting may occur. If any of these effects last or get worse, tell the doctor or pharmacist promptly. Taking this medication with food will help to reduce stomach upset ...In conclusion, this is an executive summary of a multidisciplinary guideline with recommendations for the empirical antibacterial treatment of hospitalized adults with a respiratory infection and proven or high likelihood of COVID-19. Such recommendations on treatment in COVID-19 patients need to be updated regularly, as the evidence on ...Jan 31, 2022 · 1. Introduction. The typical symptoms of coronavirus disease 2019 (COVID-19) pneumonia are fever, cough and dyspnea [].These symptoms may trigger clinicians to start empiric antibiotic treatment while waiting for diagnostic testing such as a SARS-CoV-2 polymerase chain reaction test, radiology and blood investigations. Jun 1, 2023 · Many medications are available to treat COVID-19, including oral treatments like Paxlovid (nirmatrelvir / ritonavir) and Lagevrio (molnupiravir). In late May 2023, the FDA fully approved Paxlovid for COVID-19. It’s the first oral antiviral that is approved to treat the condition. It was previously only available for emergency use. Kory recommends a weekly dose of ivermectin to prevent COVID-19 infection. "He paints himself as a savior, which then implies that every other doctor is not a savior," Dr. Graham Walker, a San ...Feb 14, 2022 · A small study suggests that treating patients who have moderate or severe COVID-19 with ceftazidime or cefepime, plus the steroid dexamethasone, is as effective as standard care. The... No safety issues were noted with use of doxycycline.Doxycycline is an attractive candidate as a repurposed drug in the treatment of COVID-19 infection, with an established safety profile, strong preclinical rationale, and compelling initial clinical experience described here. The reviews of this paper are available via the supplemental material ... Three drugs identified. After using LBVS to study approximately 4,000 drugs, then verifying their findings, the scientists identified three that may be effective against COVID-19 and, in their ...Jan 9, 2023 · Infectious (C. difficile-related) diarrhea: foul-smelling diarrhea, fever, nausea, frequent bowel movements (up to 15 times per day) The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time. In October 2020, the Food and Drug Administration (FDA) approved the use of antiviral drug remdesivir as a treatment for people age 12 and older who are hospitalized for COVID-19. Doctors had been using remdesivir since May 2020, when the FDA granted an emergency use authorization (EUA) for the drug. This is a mechanism the FDA uses to allow ...The antibiotics azithromycin and doxycycline should not be used in the management of confirmed or suspected COVID-19, the Department of Health and Social Care (DHSC) has advised. In an alert issued on 28 January 2021, the DHSC said NHS trusts must ensure that frontline medical, nursing, clinical and pharmacy teams are aware of the UK-wide recommendation […]Feb 14, 2022 · A small study suggests that treating patients who have moderate or severe COVID-19 with ceftazidime or cefepime, plus the steroid dexamethasone, is as effective as standard care. The... No safety issues were noted with use of doxycycline.Doxycycline is an attractive candidate as a repurposed drug in the treatment of COVID-19 infection, with an established safety profile, strong preclinical rationale, and compelling initial clinical experience described here. The reviews of this paper are available via the supplemental material ... Talking about COVID-19 has become a ritual for everyone. The COVID-19 pandemic has put respiratory illness—infection, pneumonia, and death—in the daily headlines. Many of us have been anticipating and dreading the next global respiratory pandemic. 2019 marked a century since the end of the 1918 H1N1 influenza A pandemic, and many marvelled at the fact that we had made it 100 years without ...1. Introduction. The typical symptoms of coronavirus disease 2019 (COVID-19) pneumonia are fever, cough and dyspnea [].These symptoms may trigger clinicians to start empiric antibiotic treatment while waiting for diagnostic testing such as a SARS-CoV-2 polymerase chain reaction test, radiology and blood investigations.Massachusetts General Hospital (MGH) COVID-19 Treatment Guidance (11) If empirical antibiotics are indicated, the recommendation is for: • Doxycycline 100 mg PO BID x 5 days or Azithromycin 500 mg PO x 1 then 250 mg PO daily for 4 days along with Ceftriaxone 1 gm IV daily. • For nonpregnant patients, doxycycline is preferred over azithromycin.Talking about COVID-19 has become a ritual for everyone. The COVID-19 pandemic has put respiratory illness—infection, pneumonia, and death—in the daily headlines. Many of us have been anticipating and dreading the next global respiratory pandemic. 2019 marked a century since the end of the 1918 H1N1 influenza A pandemic, and many marvelled at the fact that we had made it 100 years without ...May 1, 2023 · Omnicef; Descriptions. Cefdinir is used to treat bacterial infections in many different parts of the body. It belongs to the class of medicines known as cephalosporin antibiotics. It works by killing bacteria or preventing their growth. However, this medicine will not work for colds, flu, or other virus infections. Jan 9, 2023 · Infectious (C. difficile-related) diarrhea: foul-smelling diarrhea, fever, nausea, frequent bowel movements (up to 15 times per day) The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time. Treatment of adults with a current diagnosis of mild-to-moderate COVID-19 who are at high risk for progression to severe COVID-19, including hospitalization or death and forTake this medication by mouth with or without food as directed by your doctor, usually 3 times daily as needed. Swallow this medication whole. Do not chew, suck, or dissolve this medication in ... Azithromycin use was associated with a reduction in mortality and ventilation days in other viral infections. These properties could be beneficial throughout the COVID-19. However, the evidence of its use is scarce and of low quality. Azithromycin has been assessed in retrospective observational studies mainly in combination with ... May 26, 2023 · Treating COVID-19 If you have COVID-19 and are more likely to get very sick from COVID-19, treatments are available that can reduce your chances of being hospitalized or dying from the disease. Medications to treat COVID-19 must be prescribed by a healthcare provider and started as soon as possible after diagnosis to be effective. Cefdinir is used to treat bacterial infections in many different parts of the body. It belongs to the class of medicines known as cephalosporin antibiotics. It works by killing bacteria or preventing their growth. However, this medicine will not work for colds, flu, or other virus infections.We used GRADE to rate the certainty of evidence for the following primary outcomes: 1. to treat inpatients with moderate to severe COVID-19: mortality, clinical worsening defined as new need for intubation or death, clinical improvement defined as being discharged alive, quality of life, adverse and serious adverse events, and cardiac ...Azithromycin is used to treat certain bacterial infections in many different parts of the body. This medicine may mask or delay the symptoms of syphilis. It is not effective against syphilis infections. Azithromycin belongs to the class of drugs known as macrolide antibiotics. It works by killing bacteria or preventing their growth.Jul 21, 2023 · The RECOVERY trial randomized hospitalized adults with COVID-19 to receive usual care plus aspirin 150 mg per day (n = 7,351) or usual care only (n = 7,541). 37 At enrollment, 38% of the patients required NIV or mechanical ventilation. Mortality at 28 days was 17% in both arms (rate ratio 0.96; 95% CI, 0.89–1.04). Dec 23, 2021 · Treatment of adults with a current diagnosis of mild-to-moderate COVID-19 who are at high risk for progression to severe COVID-19, including hospitalization or death and for Amoxicillin and clavulanate combination is used to treat bacterial infections in many different parts of the body (eg, ear, lungs, sinus, skin, urinary tract). Amoxicillin and clavulanate combination is an antibiotic that belongs to the group of medicines known as penicillins and beta-lactamase inhibitors.The NIH recommends against the use of antibacterial therapy (e.g., azithromycin, doxycycline) for non hospitalized COVID-19 patients unless there is another medical reason to prescribe an antibiotic.These can be used as a fever reducer or to treat headache, sore throat or body aches. While ibuprofen will reduce your fever, there is some concern that it may not be safe to take with the novel coronavirus. More research needs to be done to know for sure. Stay hydrated. Fevers usually cause sweating, which means loss of water from your body.Examples include ceftriaxone (Rocephin), piperacillin-tazobactam, cefepime (Maxipime ), ceftazidime (Fortaz) , vancomycin (Firvanq) , ciprofloxacin (Cipro), and levofloxacin (Levaquin). If you ...These can be used as a fever reducer or to treat headache, sore throat or body aches. While ibuprofen will reduce your fever, there is some concern that it may not be safe to take with the novel coronavirus. More research needs to be done to know for sure. Stay hydrated. Fevers usually cause sweating, which means loss of water from your body.Sep 11, 2022 · Examples include ceftriaxone (Rocephin), piperacillin-tazobactam, cefepime (Maxipime ), ceftazidime (Fortaz) , vancomycin (Firvanq) , ciprofloxacin (Cipro), and levofloxacin (Levaquin). If you ... Three drugs identified. After using LBVS to study approximately 4,000 drugs, then verifying their findings, the scientists identified three that may be effective against COVID-19 and, in their ...Penicillin allergy: Cefpodoxime, 10 mg per kg orally per day for 10 to 14 days. Cefdinir , 14 mg per kg per day orally, divided in one to two doses for 10 to 14 days. Acute otitis media. First ...Outpatient Prescribing Trends “Trends in U.S. outpatient antibiotic prescriptions during the COVID-19 pandemic,” published online first on Dec. 29, 2020, by Clinical Infectious Diseases ...Ceftriaxone is used to treat both complicated and uncomplicated bacterial infections in adults. The recommended ceftriaxone dose for adults is between 250 mg and 2 grams per day, delivered as either a single dose or two equally divided doses given 12 hours apart. If needed, up to 4 grams can be used daily.Penicillin allergy: Cefpodoxime, 10 mg per kg orally per day for 10 to 14 days. Cefdinir , 14 mg per kg per day orally, divided in one to two doses for 10 to 14 days. Acute otitis media. First ...Azithromycin (AZM) is commonly used in Covid‐19 patients based on low‐quality evidence, increasing the risk of developing adverse events and antimicrobial resistance. The current systematic review and meta‐analysis investigated the safety and efficacy of AZM in treating Covid‐19 patients using published randomized controlled trials.Diarrhea, nausea, or vomiting may occur. If any of these effects last or get worse, tell the doctor or pharmacist promptly. Taking this medication with food will help to reduce stomach upset ...May 17, 2022 · COVID-19 is a novel disease, and treatment options are still being explored. Several drugs have been approved by the FDA to relieve symptoms and control the damaging effects of the virus in the body. As active research is being conducted, treatment options for COVID-19 continue to expand. Treatment for mild to moderate cases is called ... The antibiotics azithromycin and doxycycline should not be used in the management of confirmed or suspected COVID-19, the Department of Health and Social Care (DHSC) has advised. In an alert issued on 28 January 2021, the DHSC said NHS trusts must ensure that frontline medical, nursing, clinical and pharmacy teams are aware of the UK-wide recommendation […]Nov 11, 2020 · Talking about COVID-19 has become a ritual for everyone. The COVID-19 pandemic has put respiratory illness—infection, pneumonia, and death—in the daily headlines. Many of us have been anticipating and dreading the next global respiratory pandemic. 2019 marked a century since the end of the 1918 H1N1 influenza A pandemic, and many marvelled at the fact that we had made it 100 years without ... Oct 11, 2022 · Doxycycline doesn’t treat cystitis, but it can treat other types of UTIs, like urethritis. Chlamydia is a common cause of this type of UTI. Doxycycline is the preferred treatment for chlamydia. Dosage. A typical course of doxycycline to treat urethritis is 100 mg (by mouth) twice a day for 7 days. Side effects. Common side effects of ... Take this medication by mouth with or without food as directed by your doctor, usually 3 times daily as needed. Swallow this medication whole. Do not chew, suck, or dissolve this medication in ... No safety issues were noted with use of doxycycline.Doxycycline is an attractive candidate as a repurposed drug in the treatment of COVID-19 infection, with an established safety profile, strong preclinical rationale, and compelling initial clinical experience described here. The reviews of this paper are available via the supplemental material ...The antibiotics azithromycin and doxycycline should not be used in the management of confirmed or suspected COVID-19, the Department of Health and Social Care (DHSC) has advised. In an alert issued on 28 January 2021, the DHSC said NHS trusts must ensure that frontline medical, nursing, clinical and pharmacy teams are aware of the UK-wide recommendation […]Omnicef; Descriptions. Cefdinir is used to treat bacterial infections in many different parts of the body. It belongs to the class of medicines known as cephalosporin antibiotics. It works by killing bacteria or preventing their growth. However, this medicine will not work for colds, flu, or other virus infections.COVID-19; Diabetes; Environment & Sustainability; Exercise & Fitness; Eye Health; ... In children ages 6 months to 12 years, cefdinir is also used to treat otitis media (middle ear infection).Cefdinir (brand name Omnicef has been discontinued) is an antibiotic used to treat bacterial infections such as strep throat, E. coli, staph infections, streptococcus infections , ear infections, tonsillitis, bronchitis, and pneumonia. The most common side effects include. nausea.Dexamethasone for COVID-19. Dexamethasone is a steroid drug that has been used for years to treat inflammation from many diseases including asthma, Crohn’s disease and certain cancers. Current guidelines recommend use of dexamethasone up to 10 days, or until discharge, for patients hospitalized with COVID-19.Cefdinir is used to treat bacterial infections in many different parts of the body. It belongs to the class of medicines known as cephalosporin antibiotics. It works by killing bacteria or preventing their growth. However, this medicine will not work for colds, flu, or other virus infections.Mar 1, 2022 · The best antibiotic to treat cellulitis include dicloxacillin, cephalexin, trimethoprim with sulfamethoxazole, clindamycin, or doxycycline antibiotics. Learn what medical treatments can help ease your cellulitis symptoms and speed up your recovery. Cellulitis is a type of skin infection caused by bacteria. It is a common but serious skin condition that needs urgent medical attention. In the ... Omnicef; Descriptions. Cefdinir is used to treat bacterial infections in many different parts of the body. It belongs to the class of medicines known as cephalosporin antibiotics. It works by killing bacteria or preventing their growth. However, this medicine will not work for colds, flu, or other virus infections.Scientists are endeavoring to find antivirals specific to the virus. Several drugs such as chloroquine, arbidol, remdesivir, and favipiravir are currently undergoing clinical studies to test their efficacy and safety in the treatment of coronavirus disease 2019 (COVID-19) in China; some promising results have been achieved thus far.The best antibiotic to treat cellulitis include dicloxacillin, cephalexin, trimethoprim with sulfamethoxazole, clindamycin, or doxycycline antibiotics. Learn what medical treatments can help ease your cellulitis symptoms and speed up your recovery. Cellulitis is a type of skin infection caused by bacteria. It is a common but serious skin condition that needs urgent medical attention. In the ...Kory recommends a weekly dose of ivermectin to prevent COVID-19 infection. "He paints himself as a savior, which then implies that every other doctor is not a savior," Dr. Graham Walker, a San ... The Way You Take Prednisone Affects Immunosuppression. The method of delivery — or the way you take — prednisone matters too. People who use corticosteroids systemically (meaning orally or via injection) have a higher risk of developing immune system side effects compared to those who use the drug topically (such as for skin problems like eczema) or through an inhaler or nasal spray (such ...Feb 22, 2021 · All three drugs are used to treat mild to moderate COVID-19 in people who have a higher risk of developing serious illness due to COVID-19. Treatment consists of a single intravenous infusion given in an outpatient setting. To be most effective, these medications need to be given soon after COVID-19 symptoms start and prior to hospitalization. Chloroquine and nelfinavir were used as positive controls. Results: We revealed that the tested antibiotics exert strong capacity for binding to COVID-19 Main Protease (M pro). According to the results obtained from the GOLD docking program, ciprofloxacin and moxifloxacin bind to the protein active site more strongly than the native ligand. Azithromycin use was associated with a reduction in mortality and ventilation days in other viral infections. These properties could be beneficial throughout the COVID-19. However, the evidence of its use is scarce and of low quality. Azithromycin has been assessed in retrospective observational studies mainly in combination with ...No safety issues were noted with use of doxycycline.Doxycycline is an attractive candidate as a repurposed drug in the treatment of COVID-19 infection, with an established safety profile, strong preclinical rationale, and compelling initial clinical experience described here. The reviews of this paper are available via the supplemental material ... Methylprednisolone is used to treat conditions such as arthritis, blood disorders, severe allergic reactions, certain cancers, eye conditions, skin / kidney /intestinal/ lung diseases, and immune ...These can be used as a fever reducer or to treat headache, sore throat or body aches. While ibuprofen will reduce your fever, there is some concern that it may not be safe to take with the novel coronavirus. More research needs to be done to know for sure. Stay hydrated. Fevers usually cause sweating, which means loss of water from your body. Jan 9, 2023 · Infectious (C. difficile-related) diarrhea: foul-smelling diarrhea, fever, nausea, frequent bowel movements (up to 15 times per day) The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time. May 13, 2021 · Methods. This was a randomized, blinded, placebo-controlled trial in patients with mild-to-moderate COVID-19 symptoms randomly assigned to treatment (n = 200) and placebo (n = 200) groups. The primary outcome was duration from treatment to clinical recovery. Secondary outcomes were disease progression and persistent COVID-19 positivity by RT-PCR. Chloroquine and nelfinavir were used as positive controls. Results: We revealed that the tested antibiotics exert strong capacity for binding to COVID-19 Main Protease (M pro). According to the results obtained from the GOLD docking program, ciprofloxacin and moxifloxacin bind to the protein active site more strongly than the native ligand. Feb 2, 2021 · Hydroxychloroquine and chloroquine are oral medications that doctors use to treat malaria. In March 2020, the FDA issued an EUA for both drugs to treat COVID-19. However, they revoked this ... Oct 26, 2020 · Three drugs identified. After using LBVS to study approximately 4,000 drugs, then verifying their findings, the scientists identified three that may be effective against COVID-19 and, in their ... Jun 7, 2021 · Massachusetts General Hospital (MGH) COVID-19 Treatment Guidance (11) If empirical antibiotics are indicated, the recommendation is for: • Doxycycline 100 mg PO BID x 5 days or Azithromycin 500 mg PO x 1 then 250 mg PO daily for 4 days along with Ceftriaxone 1 gm IV daily. • For nonpregnant patients, doxycycline is preferred over azithromycin. Reactions to penicillin may include hives, below-the-skin swelling, and asthma symptoms, as well as non-allergic symptoms such as serum sickness, certain forms of anemia, and rashes. In some cases a life-threatening reaction called anaphylaxis can occur. This article will discuss how a true penicillin allergy is diagnosed, possible reactions ...The dosage is based on your medical condition and response to treatment. For the best effect, take this antibiotic at evenly spaced times. To help you remember, take this medication at the same ...
This substance helps keep the air sacs in the lungs stay open between breaths and is critical to normal lung function. As the inflammation from COVID pneumonia starts, it causes the air sacs to .... A hero
Mar 20, 2020 · SARS-CoV-2 – the coronavirus that causes the disease COVID-19 – is completely new and attacks cells in a novel way. Every virus is different and so are the drugs used to treat them. Dec 21, 2021 · Hydroxychloroquine. The drug hydroxychloroquine received a lot of attention at the beginning of the pandemic as a possible way to treat COVID-19. At one time used as an anti-malarial drug, it’s ... Feb 14, 2022 · A small study suggests that treating patients who have moderate or severe COVID-19 with ceftazidime or cefepime, plus the steroid dexamethasone, is as effective as standard care. The... Dec 29, 2020 · The study “Trends in Prescribing of Antibiotics and Drugs Investigated for Coronavirus Disease 2019 (COVID-19) Treatment in US Nursing Home Residents During the COVID-19 Pandemic,” published ... Sulfasalazine (Azulfidine), used to treat Crohn's disease, ulcerative colitis and rheumatoid arthritis; Dapsone, used to treat leprosy, dermatitis and certain types of pneumonia; Keep in mind that if you have a reaction to a sulfonamide antibiotic, you may still be able to take other sulfonamide medications without having a reaction.CEFDINIR (SEF di ner) treats infections caused by bacteria. It belongs to a group of medications called cephalosporin antibiotics. It will not treat colds, the flu, or infections caused by viruses. This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions. COMMON BRAND NAME (S): Omnicef ...This substance helps keep the air sacs in the lungs stay open between breaths and is critical to normal lung function. As the inflammation from COVID pneumonia starts, it causes the air sacs to ...Feb 14, 2022 · A small study suggests that treating patients who have moderate or severe COVID-19 with ceftazidime or cefepime, plus the steroid dexamethasone, is as effective as standard care. The... Our findings do not support the use of azithromycin in patients with mild-to-moderate COVID-19. We thank Jigar Patel and colleagues for their comments. The mean duration of symptoms at enrolment was 5·77 days (SD 3·49) in the azithromycin group and 6·27 days (3·55) in the standard care group. 19 (13%) of 147 participants in the azithromycin ...Jun 1, 2023 · Many medications are available to treat COVID-19, including oral treatments like Paxlovid (nirmatrelvir / ritonavir) and Lagevrio (molnupiravir). In late May 2023, the FDA fully approved Paxlovid for COVID-19. It’s the first oral antiviral that is approved to treat the condition. It was previously only available for emergency use. Jul 9, 2020 · Intervention and comparator: Eligible patients will be randomized to receive standard outpatient treatment only (group 1) or standard outpatient treatment plus prednisone (group 2). - Group 1: paracetamol 1 g/8 h (on demand) + hydroxychloroquine 400 mg/12h the first day, 200 mg/12 h for 4 days + azithromycin 500 mg/24h for 5 days. Doxycycline doesn’t treat cystitis, but it can treat other types of UTIs, like urethritis. Chlamydia is a common cause of this type of UTI. Doxycycline is the preferred treatment for chlamydia. Dosage. A typical course of doxycycline to treat urethritis is 100 mg (by mouth) twice a day for 7 days. Side effects. Common side effects of ...Cefdinir is a cephalosporin (SEF a low spor in) antibiotic that is used to treat many different types of infections caused by bacteria. Cefdinir may also be used for purposes not listed in this medication guide.Azithromycin (AZM) is commonly used in Covid‐19 patients based on low‐quality evidence, increasing the risk of developing adverse events and antimicrobial resistance. The current systematic review and meta‐analysis investigated the safety and efficacy of AZM in treating Covid‐19 patients using published randomized controlled trials.Diarrhea, nausea, or vomiting may occur. If any of these effects last or get worse, tell the doctor or pharmacist promptly. Taking this medication with food will help to reduce stomach upset ...May 17, 2022 · COVID-19 is a novel disease, and treatment options are still being explored. Several drugs have been approved by the FDA to relieve symptoms and control the damaging effects of the virus in the body. As active research is being conducted, treatment options for COVID-19 continue to expand. Treatment for mild to moderate cases is called ... Precautions. If your symptoms do not improve within a few days, or if they become worse, check with your doctor. Cefdinir may cause diarrhea, and in some cases it can be severe. Do not take any medicine or give medicine to your child to treat diarrhea without first checking with your doctor. Diarrhea medicines may make the diarrhea worse or ....