New papers on ivermectin combination therapy for hypoxic COVID-19 patients

These papers, published in The Japanese Journal of Antibiotics, provide a detailed epidemiological analysis based on the Bradford Hill criteria.

We are pleased to announce the successful publication of our two-part series of review papers, in which we conducted a detailed epidemiological analysis of ivermectin-based combination therapies for COVID-19, in The Japanese Journal of Antibiotics. The papers focus on ivermectin-based combination therapies that were used by the late Dr. Jackie Stone in Zimbabwe, Dr. Sabine Hazan in the United States, and Dr. Olufemi Babalola in Nigeria to treat, outside of the hospital setting, severely hypoxic patients, who under usual care would have been sent to a hospital for supplemental oxygen. Part 1 of the series conducted a very detailed statistical analysis comparing the mortality outcomes with external control groups and used a somewhat self-evident self-controlled argument regarding hospitalization rate reduction. The statistical arguments establish the strength of association Bradford Hill criterion between the combination therapy and reduction in hospitalization and mortality. A supplementary document has the computer code used for the statistical calculations and attachments for additional documentation, including the updated treatment protocol document by Dr. Jackie Stone. Part 2 reviews the literature to make the case for all other Bradford Hill criteria. We used a reformulation of the Bradford Hill criteria that was proposed by Howick and colleagues. Furthermore, Part 2 also takes on, briefly, the underlying epistemological debates concerning the use of the Bradford Hill criteria to support causality inferences. Finally, Part 2 considers the external validity of some of the negative studies that are being used by governments and public health organizations to perpetuate the false claim that ivermectin should not be used to treat COVID-19. Juxtaposing the treatments that were actually used by medical doctors at the frontlines of the pandemic against the red herrings, used by several negative studies, should be helpful towards clarifying the controversy.

Unique characteristics of these papers are our inclusion, for the first time, of the complete treatment protocol that was used by Dr. Jackie Stone and her colleagues in Zimbabwe, which was somewhat downplayed in her previous publication. Furthermore, we have included more emphasis on Jackie's use of nebulized nanosilver for treating COVID-19 patients with low oxygen saturation. Her previous paper downplayed the role of nanosilver, but Jackie was particularly enthusiastic about it. In short, nanosilver provided rapid short-term relief for patients with low oxygen saturations, and ivermectin provided less rapid but more persistent long-term relief; combining both had apparently a synergistic effect and the positive response of patients to the treatment was crystal clear.

The Japanese Journal of Antibiotics handled our papers with the utmost professionalism. They are one of the two flagship journals of the Japan Antibiotics Research Association and it has a 78-year history. Although the aims and scope of the journal are limited only to specific areas of research, they have some flexibility with review papers, and they are one of very few honest medical research journals. With the escalating prevalence of predatory retractions (i.e. the unethical retraction of valid research that runs counter to government political narratives or corporate interests) in, previously respected but now increasingly self-discredited, high impact journals, it is all the more important to support independent journals and elevate their standing and reputation by publishing good work with them.

The same journal has previously published several interesting papers by Professor Satoshi Omura's research group on the use of ivermectin for COVID-19 treatment, listed in the References section below, Professor Omura was previously honored with the Nobel Prize for the discovery of ivermectin. We are honored by the opportunity to make this contribution in aid of their efforts and hope these combined efforts will be of help to doctors from all around the world that are still being persecuted by governments and/or medical boards for using or having used ivermectin to treat COVID-19.

Addendum: Many thanks to Nicolas Hulscher for his very nice summary and graphical abstracts of our papers.

References

1. E. Gkioulekas, P.A. McCullough, C. Aldous: "Critical appraisal of multi-drug therapy in the ambulatory management of patients with COVID-19 and hypoxemia. Part I. Evidence supporting the strength of association", The Japanese Journal of Antibiotics 78(1) (2025), 2-34

2. E. Gkioulekas, P.A. McCullough, C. Aldous: "Critical appraisal of multi-drug therapy in the ambulatory management of patients with COVID-19 and hypoxemia. Part II: Causal inference using the Bradford Hill criteria", The Japanese Journal of Antibiotics 78(1) (2025), 35-68

3. J. Howick, P. Glasziou, J.K. Aronson, "The evolution of evidence hierarchies: what can Bradford Hill's 'guidelines for causation' contribute?", Journal of the Royal Society of Medicine 102(5) (2009), 186-94

4. J.C. Stone, P. Ndarukwa, D.E. Scheim, BM Dancis, J. Dancis, M.G. Gill, C. Aldous, "Changes in SpO2 on Room Air for 34 Severe COVID-19 Patients after Ivermectin-Based Combination Treatment: 62% Normalization within 24 Hours", Biologics. 2022 2(3) (2022), 196-210.

5. M. Yagisawa, P.J. Foster, H. Hanaki, S. Omura, "Global Trends in clinical studies of ivermectin in COVID-19", The Japanese Journal of Antibiotics 74 (1) (2021), 44-95

6. M. Yagisawa, P.J. Foster, H. Hanaki, S. Omura, "Global trends in novel coronavirus infection (COVID-19) and its treatment -Analyses of the background of ivermectin clinical trials-", The Japanese Journal of Antibiotics 76(2)(2023), 56-108

7. M. Yagisawa, P.J. Foster, H. Hanaki, S. Omura, "Global Trends in clinical studies of ivermectin in COVID-19. Part 2", The Japanese Journal of Antibiotics 77 (1) (2024), 45-92