Azithromycin Fails In Treating COVID-19

Early during the pandemic, azithromycin was thought to be effective against SARS-CoV-2. However, a randomized controlled trial from the UK revealed that azithromycin offers no clinical benefit. The Randomized Evaluation of COVID-19 Therapy (RECOVERY) trial included azithromycin, and immunomodulators, among its panel of therapies for evaluation. Several o these potential treatment modalities were compared in UK patients with COVID-19 who were hospitalized.

These included azithromycin, dexamethasone, hydroxychloroquine, and lopinavir-ritonavir, tocilizumab, convalescent plasma, REGEN-COV2 (a combination of two anti-SARS-CoV-2 spike monoclonal antibodies), aspirin, and colchicine. In the current study, the patients were assigned usual care or usual care plus azithromycin. The patients in the azithromycin arm received either 500mg by mouth, IV, or nasogastric tube for 10 days or until discharge.

The researchers found no difference in deaths. The same results were obtained when the groups were stratified further by age, sex, ethnic origin, corticosteroid use, type of respiratory support, etc. The time to discharge from the hospital was also the same in both arms. Among patients who were not on mechanical ventilation at baseline, the risk of requiring ventilation or of death was again similar in both arms, at 21% and 22%. 

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