In the randomized clinical trial, there was no significant difference in symptom absence 14 days after drug administration between individuals given azithromycin and the placebo. Furthermore, the azithromycin group visited the emergency room more frequently than the placebo group.
Azithromycin has conjured excitement amongst medical researchers as a potential drug to combat COVID-19. If it could show that it reduces the severity of symptoms in COVID-19 positive patients, azithromycin could be an excellent candidate for outpatient therapy, as it is inexpensive, readily available, and has a low risk of side effects.
Azithromycin is a wide-ranging antibiotic that is known for its anti-inflammatory and antiviral properties. It’s been hypothesized that it could be effective against SARS-CoV-2. The drug is generally used to treat or prevent lung infections that typically affect HIV patients, as well as to treat bacterial infections such as bronchitis, STDs, and ear infections.
In a recently published study, researchers found that for outpatients with SARS-CoV-2 infection, treatment with a single dose of oral azithromycin did not result in a greater chance of being symptom-free at day 14 when compared to a placebo.
The study states, “At day 14, there was no significant difference in proportion of participants who were symptom free,” in regard to the test population in which 50% of patients were treated with Azithromycin, and 50% were treated with a placebo.
Hydroxychloroquine is another drug candidate that has been of great interest to researchers attempting to find drugs, as well as possible drug combinations, that could aid in the fight against COVID-19. In randomized clinical trials of hospitalized patients and outpatients with suspected COVID-19, there has been no evidence to support the use of azithromycin for COVID-19 therapy with or without hydroxychloroquine. Many have hypothesized that hydroxychloroquine may be most effective as a prophylactic, but studies have yet to prove its preventative efficacy.
The new study was a 2:1 randomized clinical trial that used a single 1.2-g oral dose of azithromycin for the participants in the azithromycin-treatment group. Participants were randomly assigned to either azithromycin or a placebo. During treatment administration, the drug bottle labeling was identical to enable for masking of investigators, drug administrators, and participants.
All hospitalizations occurred in the azithromycin group. Additionally, the azithromycin group used the emergency department more than the placebo group. The researchers noted that, antibiotic overuse during the COVID-19 pandemic may have resulted in increasing antimicrobial resistance selection.
The study concluded by stating, “Among outpatients with SARS-CoV-2 infection, treatment with a single dose of azithromycin compared with placebo did not result in greater likelihood of being symptom free at day 14…However, given that azithromycin is routinely prescribed to patients with COVID-19 in lower-risk subgroups, broad inclusion may improve generalizability to lower-risk outpatient management.”
The study was published in JAMA, on July 16th, 2021.
Oldenburg CE, Pinsky BA, Brogdon J, et al. Effect of Oral Azithromycin vs Placebo on COVID-19 Symptoms in Outpatients With SARS-CoV-2 Infection: A Randomized Clinical Trial. JAMA. Published online July 16, 2021. doi:10.1001/jama.2021.11517
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