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Use of hydroxychloroquine and azithromycin combination to treat the COVID-19 infection

Jyoti Bajpai1, Akshyaya Pradhan2, Ajay Kumar Verma1

  • 1Department of Respiratory Medicine, King George's Medical University, Lukcnow, Lucknow 226003, Uttar Pradesh, India.

World Journal of Experimental Medicine
|June 29, 2022
PubMed

Insights

Hydroxychloroquine and azithromycin combination therapy showed increased adverse events in COVID-19 patients. Large randomized trials are needed to confirm findings, but hydroxychloroquine use is now banned.

Area of Science:

  • Infectious Diseases
  • Pharmacology
  • Clinical Medicine

Background:

  • Coronavirus disease 2019 (COVID-19) presents a global health crisis with no definitive therapy.
  • Hydroxychloroquine (HCQS) and azithromycin (AZ) were explored for potential antiviral effects against SARS-CoV-2.
  • Conflicting evidence exists regarding the efficacy and safety of the HCQS+AZ combination for COVID-19 management.

Purpose of the Study:

  • To review the pharmacology, clinical trials, treatment regimens, and side effects of combined hydroxychloroquine and azithromycin therapy for COVID-19.
  • To synthesize current evidence on the use of HCQS+AZ in managing COVID-19.
  • To highlight the need for further research, particularly large randomized trials, despite recent bans on HCQS.

Main Methods:

  • Literature review of pharmacological properties of HCQS and AZ.
  • Analysis of data from clinical trials investigating HCQS+AZ for COVID-19.
  • Examination of observational studies reporting adverse events associated with HCQS+AZ therapy.

Main Results:

  • In vitro studies suggested antiviral activity for HCQS and AZ against SARS-CoV-2.
  • Observational studies indicated a significant association between HCQS+AZ combination therapy and increased adverse events.
  • Evidence regarding the clinical efficacy of HCQS+AZ remains inconclusive.

Conclusions:

  • The combination of hydroxychloroquine and azithromycin has been associated with increased adverse events in COVID-19 patients.
  • While observational studies suggest risks, large randomized controlled trials are crucial for definitive conclusions on HCQS+AZ efficacy and safety.
  • The clinical utility of HCQS+AZ for COVID-19 is questionable, especially given the ban on HCQS use in many regions.

Keywords:
Antiviral effectsAzithromycinHydroxychloroquineQT intervalRandomized controlled trial

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