{"id":37524,"date":"2020-04-17T07:41:14","date_gmt":"2020-04-17T07:41:14","guid":{"rendered":"http:\/\/i-base.info\/htb\/?p=37524"},"modified":"2020-05-23T18:50:18","modified_gmt":"2020-05-23T18:50:18","slug":"no-benefit-of-hydroxychloroquine-and-azithromycin-in-11-people-hospitalised-with-covid-19","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/37524","title":{"rendered":"No benefit of hydroxychloroquine and azithromycin in people hospitalised with COVID-19"},"content":{"rendered":"

Simon Collins, HIV i-Base<\/span><\/strong><\/p>\n

A prospective open label study of 11 people (7 men and 4 women) hospitalised with COVID-19 (10\/11 with fever) at a single hospital in Paris, reported no benefits from using the antimalaria drug hydroxychloroquine with the antibiotic azithromycin. [1]<\/span><\/strong><\/p>\n

The results are important for challenging an earlier French study (from Gautret et al) that reported CoV-2 clearance in 6\/26 people using this combination. It led to widespread speculation as an effective treatment that resulted in pharmacy stock-outs within 24 hours. This has drained resources for genuine need (for example, lupus and rheumatoid arthritis). [2, 3]<\/span><\/p>\n

The new study was authored by Jean-Michel Molina and colleagues from Saint Louis Hospital, Paris<\/span> and published ahead of print in the French journal <\/span>M\u00e9decine et Maladies Infectieuses.<\/p>\n

Baseline characteristics included mean age of 58 years (range: 20 to 77) and 8\/11 had significant comorbidities associated with poor outcomes (obesity: 2; solid cancer: 3; hematological cancer: 2; HIV-infection: 1). <\/span><\/p>\n

The treatment included hydroxychloroquine (600 mg\/d for 10 days) and azithromycin (500 mg day 1 and 250 mg days 2 to 5). <\/span><\/p>\n

After five days, CoV-2 remained detectable by qualitative PCR in throat swabs in all participants.<\/p>\n

One patient died and two were transferred to intensive care units. One participant discontinued treatment after four days due to qT prolongation (from <\/span>405 ms to 460 and 470 ms).<\/p>\n

The paper by Molina et al references a<\/span> recent randomised study from China that also reported no benefit from hydroxychloroquine and azithromycin in 30 participants, with similar rates of clearance to a control group. In this study, throat swabs were negative by PCR at day seven in 86% of the active vs 93% of the standard of care control groups, and with no differences in clinical outcomes. [4]<\/span><\/p>\n

It also references other studies showing no impact in other indications and was published as an alert to counter the high publicity given to this combination.<\/span><\/p>\n

Reference<\/span><\/p>\n

    \n
  1. Molina JM et al. No evidence of rapid antiviral clearance or clinical benefit with the combination of hydroxychloroquine and azithromycin in patients with severe COVID-19 infection. <\/span>M\u00e9decine et Maladies Infectieuses <\/i>(2020), doi: 10.1016\/j.medmal.2020.03.006.
    \nhttps:\/\/www.sciencedirect.com\/science\/article\/pii\/S0399077X20300858<\/a><\/li>\n
  2. Gautret P et al. Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial. International Journal of Antimicrobial Agents 2020 (ahead of print).
    \n    https:\/\/www.sciencedirect.com\/science\/article\/pii\/S0924857920300996<\/a><\/li>\n
  3. Yazdany J. Use of hydroxychloroquine and chloroquine during the COVID-19 pandemic: what every clinician should know. Ann Intern Med.\u00a02020.\u00a0DOI:\u00a010.7326\/M20-1334.
    \n<\/span>    https:\/\/annals.org\/aim\/fullarticle\/2764199\/use-hydroxychloroquine-chloroquine-during-covid-19-pandemic-what-every-clinician<\/span><\/a><\/li>\n
  4. Chen J et al.\u00a0A pilot study of hydroxychloroquine in treatment of patients with common coronavirus disease-19 (COVID-19). Journal of Zhejiang University (Medical Sciences). 2020;49(1). doi:10.3785\/j.issn.1008-9292.2020.03.03.
    \n    http:\/\/www.zjujournals.com\/med\/EN\/10.3785\/j.issn.1008-9292.2020.03.03<\/a><\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    Simon Collins, HIV i-Base A prospective open label study of 11 people (7 men and 4 women) hospitalised with COVID-19 (10\/11 with fever) at a single hospital in Paris, reported no benefits from using the antimalaria drug hydroxychloroquine with the …<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[283,278],"tags":[],"class_list":["post-37524","post","type-post","status-publish","format-standard","hentry","category-covid-19-investigational-drugs","category-covid-19"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/37524","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=37524"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/37524\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=37524"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=37524"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=37524"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}