Azithromycin use in Covid- 19: A tale of changing guidelines

It has been more than two years since the arrival of Covid-19 pandemic on world stage. When we look back during landmark events of last two years, several ones stand out. And one of these is utilization and then going out- of- favor of use of an antibiotic – Azithromycin. Pilva- a Croatian pharmaceutical company- headquartered in Zagreb in late 1970s discovered the drug. Then several years of research yielded a product which was highly effective and provided good therapeutic results. As this was a small company having limited resources, it made a licensing agreement with Pfizer to sell the drug at marked geographies. While initial reason of its use in SARS-CoV-2 infection was its supposedly immunomodulatory effect yet randomized controlled trials demonstrated a lack of a beneficial effect for this indication. Therefore, when recollecting our journey with the mutant Coronavirus during last two years, it’s necessary to remember that when trying to discover a useful drug for the disease, we had several misses as well. As usual in Medical science, most of the hits have several collateral misses, even though this drug carries with it certain unique features. In the Editorial I chronicle a few such distinguishing features.