CovidChloroV1, Main, Corpus, bibRecord, 001722

Should azithromycin be used to treat COVID-19? A rapid review.

Identifieur interne : 001722 ( Main/Corpus ); précédent : 001721; suivant : 001723

Should azithromycin be used to treat COVID-19? A rapid review.

Auteurs : Kome Gbinigie ; Kerstin Frie

Source :

BJGP open [ 2398-3795 ] ; 2020.

RBID : pubmed:32398343

Abstract

BACKGROUND

There are no established effective treatments for COVID-19. While novel drugs are being developed, azithromycin has been identified as a candidate treatment in the interim.

AIM

To review the evidence for the effectiveness and safety of azithromycin in treating COVID-19.

DESIGN & SETTING

A rapid review of the literature was conducted.

METHOD

Electronic searches were conducted on 16 April 2020 of PubMed, TRIP, EPPI COVID Living Map, MedRxiv, GoogleScholar, and Google. In vivo and in vitro studies were included assessing the safety and effectiveness of azithromycin for treatment of COVID-19, and/or the activity of azithromycin against SARS-CoV-2. In vivo studies needed to include a comparator group.

RESULTS

Three studies were identified, two in vitro and one in vivo, which were suitable for inclusion. All three were published as pre-prints. The in vitro studies revealed conflicting results, with one finding anti-SARS-CoV-2 activity for azithromycin alone, while the other found activity against SARS-CoV-2 only when azithromycin was combined with hydroxychloroquine. A small trial of 36 patients, with high risk of bias, found superior viral clearance in patients with COVID-19 treated with azithromycin and hydroxychloroquine combined, compared with hydroxychloroquine alone.

CONCLUSION

There is no evidence to support the use of azithromycin for the treatment of COVID-19 outside of the context of clinical trials, unless it is used to treat bacterial super-infection. There is extremely limited evidence of a possible synergy between azithromycin and hydroxychloroquine. The adverse events profile of azithromycin in the context of COVID-19 has not yet been established. Well-conducted clinical trials are urgently needed in this area.

DOI: 10.3399/bjgpopen20X101094
PubMed: 32398343
PubMed Central: PMC7330212

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pubmed:32398343

Le document en format XML

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<author><name sortKey="Gbinigie, Kome" sort="Gbinigie, Kome" uniqKey="Gbinigie K" first="Kome" last="Gbinigie">Kome Gbinigie</name>
<affiliation><nlm:affiliation>GP and DPhil Student, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK Oghenekome.gbinigie@phc.ox.ac.uk.</nlm:affiliation>
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<author><name sortKey="Frie, Kerstin" sort="Frie, Kerstin" uniqKey="Frie K" first="Kerstin" last="Frie">Kerstin Frie</name>
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<front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b>
</p>
<p>There are no established effective treatments for COVID-19. While novel drugs are being developed, azithromycin has been identified as a candidate treatment in the interim.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>AIM</b>
</p>
<p>To review the evidence for the effectiveness and safety of azithromycin in treating COVID-19.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>DESIGN & SETTING</b>
</p>
<p>A rapid review of the literature was conducted.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>METHOD</b>
</p>
<p>Electronic searches were conducted on 16 April 2020 of PubMed, TRIP, EPPI COVID Living Map, MedRxiv, GoogleScholar, and Google. In vivo and in vitro studies were included assessing the safety and effectiveness of azithromycin for treatment of COVID-19, and/or the activity of azithromycin against SARS-CoV-2. In vivo studies needed to include a comparator group.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>RESULTS</b>
</p>
<p>Three studies were identified, two in vitro and one in vivo, which were suitable for inclusion. All three were published as pre-prints. The in vitro studies revealed conflicting results, with one finding anti-SARS-CoV-2 activity for azithromycin alone, while the other found activity against SARS-CoV-2 only when azithromycin was combined with hydroxychloroquine. A small trial of 36 patients, with high risk of bias, found superior viral clearance in patients with COVID-19 treated with azithromycin and hydroxychloroquine combined, compared with hydroxychloroquine alone.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>CONCLUSION</b>
</p>
<p>There is no evidence to support the use of azithromycin for the treatment of COVID-19 outside of the context of clinical trials, unless it is used to treat bacterial super-infection. There is extremely limited evidence of a possible synergy between azithromycin and hydroxychloroquine. The adverse events profile of azithromycin in the context of COVID-19 has not yet been established. Well-conducted clinical trials are urgently needed in this area.</p>
</div>
</front>
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Should azithromycin be used to treat COVID-19? A rapid review.

Should azithromycin be used to treat COVID-19? A rapid review.

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Abstract

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