COVID-19 Management

Prospective Trial Results (France): Hydroxychloroquine and Azithromycin Provide No Clinical Benefit for COVID-19

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BACKGROUND AND PURPOSE:

  • A small French study by Gautret et al. (International Journal of Antimicrobial Agents, 2020) found 100% viral clearance in COVID-19 patients who received hydroxychloroquine and azithromycin
  • Molina et al. (Médecine et Maladies Infectieuses, 2020) followed up this study by assessing virologic and clinical outcomes using the same dosing regimen

METHODS:

  • Prospective study
  • Participants
    • Consecutive hospitalized COVID-19 patients
  • Intervention
    • Hydroxychloroquine, 600 mg/d for 10 days
    • Azithromycin 500 mg Day 1, 250 mg days 2 to 5

RESULTS:

  • 11 patients were treated
    • 7 men | mean (range) age 58.7 years (20 to 77)
    • 8 had significant comorbidities (obesity, solid and hematological cancer, HIV-infection)
  • At time of treatment 10 of the 11 patients had a fever and received nasal oxygen therapy
  • Within 5 days
    • 1 patient had died
    • 2 had been transferred to the ICU
  • In one patient, hydroxychloroquine and azithromycin were discontinued after 4 days due to a prolongation of QT interval
  • Viral clearance at days 5 to 6 after treatment: 80%
    • At days 5 to 6 after treatment, nasopharyngeal swabs were still positive for viral RNA in 80% of patients (95% CI, 49 to 94%)

CONCLUSION:

  • This study found no evidence for a clinical benefit of combination hydroxychloroquine and azithromycin in COVID-19 patients
    • Results corroborates the results of a study from China, which also found that this combination did not affect viral clearance or clinical outcome
    • The authors state

Ongoing randomised clinical trials with hydroxychloroquine should provide a definitive answer regarding the alleged efficacy of this combination and will assess its safety

Learn More – Primary Sources:

No Evidence of Rapid Antiviral Clearance or Clinical Benefit with the Combination of Hydroxychloroquine and Azithromycin in Patients with Severe COVID-19 Infection (Médecine et Maladies Infectieuse, 2020)

Hydroxychloroquine and Azithromycin as a Treatment of COVID-19: Results of an Open-Label Non-Randomized Clinical Trial (International Journal of Antimicrobial Agents, 2020)

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