Commonly prescribed COVID-19 antibiotic azithromycin no better than a placebo

SAN FRANCISCO — A surprising new study from the University of California, San Francisco reports that azithromycin, an antibiotic frequently prescribed to COVID patients, offers little to no benefits in terms of fighting the coronavirus. More specifically, researchers conclude that azithromycin is no more effective than a placebo at preventing COVID symptoms among non-hospitalized patients.

On the contrary, azithromycin may actually increase the likelihood of such individuals requiring hospitalization.

“These findings do not support the routine use of azithromycin for outpatient SARS-CoV-2 infection,” says lead author Catherine E. Oldenburg, ScD, MPH, an assistant professor with the UCSF Proctor Foundation, in a university release.

Azithromycin is a broad spectrum antibiotic, and has been prescribed all over the world to COVID patients since the start of the pandemic. Why? The idea is that the drug’s anti-inflammatory effect may help subdue COVID-related symptoms. “The hypothesis is that it has anti-inflammatory properties that may help prevent progression if treated early in the disease,” Dr. Oldenburg explains. “We did not find this to be the case.”

This research focused on 263 individuals who had all tested positive for COVID-19 within a seven day timeframe of enrolling in this project. At the time of enrollment none were experiencing symptoms severe enough to warrant hospitalization. Then, 171 subjects were randomly given a single, 1.2 gram oral dose of azithromycin. Meanwhile, another 92 received a placebo.

By day 14 of the observation period about 50 percent of all participants were still symptom-free. Fast forward to the three-week mark, and five patients required hospitalization. Surprisingly, all five of those individuals had been given actual azithromycin, not the placebo.

In light of these findings study authors conclude that a single dose of azithromycin offers little protective COVID benefits in comparison to a placebo.

“Most of the trials done so far with azithromycin have focused on hospitalized patients with pretty severe disease,” Dr. Oldenburg concludes. “Our paper is one of the first placebo-controlled studies showing no role for azithromycin in outpatients.”

The study is published in JAMA.