A leading author of a recent Oxford study speaks of azithromycin, its limitations in treating patients with COVID-19, and the importance of properly utilizing the antibiotic.
Azithromycin is an antibiotic with antiviral and anti-inflammatory properties that has been used to treat a variety of human viruses. However, recent data published by investigators from the Nuffield Dept of Medicine in the UK revealed that the antibiotic had no significant impact on the wellbeing of patients with COVID-19.
The study involved 1 of 3 clinical trials from Oxford, UK. The first 2 trials (the RECOVERY and PRINCIPAL trials) studied patients at various points of progression with the COVID-19 virus.
For the recent trial, investigators wanted to study patients who were at a specific point in their experience with the virus.
“We wanted to look at people with moderate disease who were at high-risk of progression and high-risk disease but who still had a window of opportunity for both its antiviral and anti-inflammatory properties to act,” said Dr. Timothy Hinks, MD, in an interview with HCPLive.
Hinks noted the effectiveness of azithromycin regarding asthma and rhinovirus induced exacerbations. It has also been an important tool in silico and invitro drug screens.
Despite this, the findings from the most recent study suggested that the antibiotic had little-to-no impact on the wellbeing of patients with COVID-19. Peak severity scores in both the azithromycin group and the standard group were very similar, at 40% and 44%, respectively.
“I have to be really clear: azithromycin does not work in COVID-19. These differences (in peak severity scores) would be easily within the bounds of random fluctuation,” Hinks said.
While it’s possible the study could have benefitted from a larger population, larger studies on the azithromycin and COVID-19 had shown no statistically meaningful effect.
Hinks did not see a future for the study of the antibiotic and its impact on the virus, although the findings in the study will be used for a wide array of meta-analyses soon.
“More importantly for the drug going forward: assuming all these meta-analyses find strong evidence of no benefit then it’s going to be really important to protect this precious antibiotic,” he said.
He noted that antibiotic is on World Health Organization’s list of essential medicines for any healthcare infrastructure, as it can be used to treat bacterial pneumonia, trachoma, genital urinary infections, and for treatment of multidrug resistant TB.
“It’s essential that we only use this medicine where there’s a strong indication and we’re very excited that are data are contributing to the basis on which we’re going to protect this (and) where this is really useful,” Hinks said.