A small study has found that the antibiotic azithromycin had no effect in prevention of COVID symptoms among non-hospitalised patients, and could increase hospitalisation risk, even though the antibiotic is widely used for the disease.
“These findings do not support the routine use of azithromycin for outpatient SARS-CoV-2 infection,” said lead author Catherine E Oldenburg, ScD, MPH, an assistant professor with the UCSF Proctor Foundation.
Azithromycin, a broad-spectrum antibiotic of the macrolide class, is widely prescribed as a treatment for COVID-19 in the United States and the rest of the world. “The hypothesis is that it has anti-inflammatory properties that may help prevent progression if treated early in the disease,” said Oldenburg. “We did not find this to be the case.”
The study was published in the Journal of the American Medical Association.
The study recruited 263 non-hospitalised participants who had tested positive for SARS-CoV-2 seven days or sooner before entering the study. Of these, 171 participants were randomised to receive\ a single, 1.2 gram oral dose of azithromycin and 92 received an identical placebo.
At day 14, 50 percent of the participants remained symptom-free in both groups. By day 21, five of the participants who received azithromycin had been hospitalised with severe COVID symptoms and none of the placebo group had been hospitalised.
From these findings, the researchers concluded that treatment with a single dose of azithromycin compared to placebo did not result in greater likelihood of being symptom-free.
“Most of the trials done so far with azithromycin have focused on hospitalised patients with pretty severe disease,” said Oldenburg. “Our paper is one of the first placebo-controlled studies showing no role for azithromycin in outpatients.”
The PRINCIPLE study being conducted in the UK investigating common medications for community treatment of moderate COVID also found no benefit to using azithromycin.
Source: University of California, San Francisco
Journal information: Catherine E. Oldenburg et al, Effect of Oral Azithromycin vs Placebo on COVID-19 Symptoms in Outpatients With SARS-CoV-2 Infection, JAMA (2021). DOI: 10.1001/jama.2021.11517
