What is the evidence for use of macrolide antibiotics for treatment of COVID-19?, CEBM

We identified three studies, two in vitro and one in vivo, assessing the use of macrolide antibiotics for the treatment of COVID-19. Each of these studies assessed treatment with azithromycin. The evidence from the in vivo study and one in vitro study suggest a possible synergy between azithromycin and hydroxychloroquine. However, the in vivo study had a small number of participants and was methodologically flawed; the findings must therefore be treated with caution. The two in vitro studies provided conflicting results regarding the activity of azithromycin alone against SARS-CoV-2; one found that azithromycin alone had activity against the virus, whilst the other found anti-SARS-CoV-2 activity only when azithromycin was combined with hydroxychloroquine. At present, there is insufficient evidence to recommend treatment with macrolides, alone or combined with hydroxychloroquine, for COVID-19 outside of research. Both macrolide antibiotics and hydroxychloroquine can increase the QT interval; combining these drugs may therefore result in cardiovascular harms. Clinicians may wish to use macrolide antibiotics to treat a bacterial super-infection that has complicated COVID-19, in line with local/national treatment protocols.
Source: Current Awareness Service for Health (CASH) - Category: Consumer Health News Source Type: news