Azitromicina en pacientes ingresados en el hospital con COVID-19 (RECUERDA): un ensayo de plataforma aleatorizado,
Lancet (London, England)
|February 5, 2021
Resumen
La azitromicina no mejoró la supervivencia de los pacientes hospitalizados con COVID-19 en el ensayo RECOVERY. Su uso debe limitarse a los casos con una clara indicación antimicrobiana, no para el tratamiento de COVID-19.
Área de la Ciencia:
- Medicina Clínica
- Enfermedades infecciosas
- Farmacología
Sus antecedentes:
- La azitromicina, un antibiótico con propiedades inmunomoduladoras, fue investigado para el tratamiento de la COVID-19.
- El estudio evaluó la seguridad y eficacia de la azitromicina en pacientes hospitalizados con COVID-19.
Objetivo del estudio:
- Evaluar la efectividad de la azitromicina para mejorar los resultados clínicos de los pacientes hospitalizados con COVID-19.
- Determinar si la azitromicina reduce la mortalidad a los 28 días en esta población de pacientes.
Principales métodos:
- Un ensayo de plataforma adaptativa aleatorizado, controlado y abierto (RECOVERY) en el que participaron 7.763 pacientes hospitalizados con COVID-19.
- Los pacientes recibieron el tratamiento habitual más azitromicina (500 mg al día) o el tratamiento habitual solo.
- El resultado primario fue la mortalidad por cualquier causa a los 28 días.
Principales resultados:
- La administración de azitromicina no alteró significativamente la mortalidad por cualquier causa a los 28 días (22% en ambos grupos; índice de tasa 0,97, IC del 95% 0,87-1,07).
- No se observaron diferencias significativas en la duración de la estancia hospitalaria o en las tasas de supervivencia a los 28 días.
- El resultado compuesto de ventilación mecánica o muerte tampoco mostró diferencias significativas entre los grupos.
Conclusiones:
- La azitromicina no es efectiva para mejorar la supervivencia u otros resultados clínicos en pacientes hospitalizados con COVID-19.
- El uso de azitromicina en pacientes hospitalizados con COVID-19 debe reservarse para situaciones con una infección bacteriana confirmada.
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