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Azithromycin in COVID-19 Patients: Pharmacological Mechanism, Clinical Evidence and Prescribing Guidelines

The global COVID-19 pandemic has led to a race to find medications that can improve the prognosis of the disease. Azithromycin, in association with hydroxychloroquine or chloroquine, has been proposed as one such medication. The aim of this review is to describe the pharmacological mechanism, clinic...

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Autores principales: Sultana, Janet, Cutroneo, Paola Maria, Crisafulli, Salvatore, Puglisi, Gabriele, Caramori, Gaetano, Trifirò, Gianluca
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7371963/
https://www.ncbi.nlm.nih.gov/pubmed/32696429
http://dx.doi.org/10.1007/s40264-020-00976-7
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author Sultana, Janet
Cutroneo, Paola Maria
Crisafulli, Salvatore
Puglisi, Gabriele
Caramori, Gaetano
Trifirò, Gianluca
author_facet Sultana, Janet
Cutroneo, Paola Maria
Crisafulli, Salvatore
Puglisi, Gabriele
Caramori, Gaetano
Trifirò, Gianluca
author_sort Sultana, Janet
collection PubMed
description The global COVID-19 pandemic has led to a race to find medications that can improve the prognosis of the disease. Azithromycin, in association with hydroxychloroquine or chloroquine, has been proposed as one such medication. The aim of this review is to describe the pharmacological mechanism, clinical evidence and prescribing guidelines concerning azithromycin in COVID-19 patients. There is weak evidence on the antiviral and immunomodulating effects of azithromycin, which in addition is not based on results from COVID-19 patients specifically. Therefore, this antibacterial should be considered only as empirical treatment of community-acquired pneumonia (CAP), although not all current treatment guidelines are in agreement. After the initial expectations raised by a small trial, more recent evidence has raised serious safety concerns on the use of hydroxychloroquine or chloroquine with azithromycin to treat COVID-19 patients, as all these drugs have arrhythmogenic potential. The World Health Organization has not made recommendations suggesting the use of azithromycin with hydroxychloroquine or chloroquine as treatment for COVID-19, but some national organisations have taken a different position, recommending this as first-line treatment. Several scientific societies, including the American College of Cardiology, have cautioned about the risks of this treatment in view of the lack of evidence concerning its benefits.
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spelling pubmed-73719632020-07-21 Azithromycin in COVID-19 Patients: Pharmacological Mechanism, Clinical Evidence and Prescribing Guidelines Sultana, Janet Cutroneo, Paola Maria Crisafulli, Salvatore Puglisi, Gabriele Caramori, Gaetano Trifirò, Gianluca Drug Saf Current Opinion The global COVID-19 pandemic has led to a race to find medications that can improve the prognosis of the disease. Azithromycin, in association with hydroxychloroquine or chloroquine, has been proposed as one such medication. The aim of this review is to describe the pharmacological mechanism, clinical evidence and prescribing guidelines concerning azithromycin in COVID-19 patients. There is weak evidence on the antiviral and immunomodulating effects of azithromycin, which in addition is not based on results from COVID-19 patients specifically. Therefore, this antibacterial should be considered only as empirical treatment of community-acquired pneumonia (CAP), although not all current treatment guidelines are in agreement. After the initial expectations raised by a small trial, more recent evidence has raised serious safety concerns on the use of hydroxychloroquine or chloroquine with azithromycin to treat COVID-19 patients, as all these drugs have arrhythmogenic potential. The World Health Organization has not made recommendations suggesting the use of azithromycin with hydroxychloroquine or chloroquine as treatment for COVID-19, but some national organisations have taken a different position, recommending this as first-line treatment. Several scientific societies, including the American College of Cardiology, have cautioned about the risks of this treatment in view of the lack of evidence concerning its benefits. Springer International Publishing 2020-07-21 2020 /pmc/articles/PMC7371963/ /pubmed/32696429 http://dx.doi.org/10.1007/s40264-020-00976-7 Text en © Springer Nature Switzerland AG 2020 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
spellingShingle Current Opinion
Sultana, Janet
Cutroneo, Paola Maria
Crisafulli, Salvatore
Puglisi, Gabriele
Caramori, Gaetano
Trifirò, Gianluca
Azithromycin in COVID-19 Patients: Pharmacological Mechanism, Clinical Evidence and Prescribing Guidelines
title Azithromycin in COVID-19 Patients: Pharmacological Mechanism, Clinical Evidence and Prescribing Guidelines
title_full Azithromycin in COVID-19 Patients: Pharmacological Mechanism, Clinical Evidence and Prescribing Guidelines
title_fullStr Azithromycin in COVID-19 Patients: Pharmacological Mechanism, Clinical Evidence and Prescribing Guidelines
title_full_unstemmed Azithromycin in COVID-19 Patients: Pharmacological Mechanism, Clinical Evidence and Prescribing Guidelines
title_short Azithromycin in COVID-19 Patients: Pharmacological Mechanism, Clinical Evidence and Prescribing Guidelines
title_sort azithromycin in covid-19 patients: pharmacological mechanism, clinical evidence and prescribing guidelines
topic Current Opinion
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7371963/
https://www.ncbi.nlm.nih.gov/pubmed/32696429
http://dx.doi.org/10.1007/s40264-020-00976-7
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