Reply to Gautret et al: hydroxychloroquine sulfate and azithromycin for COVID-19: what is the evidence and what are the risks?

Int J Antimicrob Agents. 2020 Jul;56(1):106056. doi: 10.1016/j.ijantimicag.2020.106056. Epub 2020 Jul 13.

Abstract

The severity of COVID-19 has resulted in a global rush to find the right antiviral treatment to conquer the pandemic and to treat patients. This requires reliable studies to support treatment. In a recently published study by Gautret et al. the authors concluded that hydroxychloroquine monotherapy and hydroxychloroquine in combination with azithromycin reduced viral load. However, this trial has several major methodological issues, including the design, outcome measure and the statistical analyses. In this paper we discuss the background, clinical evidence, pharmacology and methodological issues related to this clinical trial. We understand the rush to release results, however in case conclusions are far reaching the evidence needs to be robust.

Keywords: (Hydroxy)chloroquine; 2019-nCoV; Azithromycin; COVID-19; SARS-CoV-2.

Publication types

  • Review

MeSH terms

  • Azithromycin / administration & dosage*
  • Azithromycin / adverse effects
  • Azithromycin / pharmacology
  • Betacoronavirus*
  • COVID-19
  • COVID-19 Drug Treatment
  • Clinical Trials as Topic
  • Coronavirus Infections / drug therapy*
  • Drug Therapy, Combination
  • Humans
  • Hydroxychloroquine / administration & dosage*
  • Hydroxychloroquine / adverse effects
  • Hydroxychloroquine / pharmacology
  • Outcome Assessment, Health Care
  • Pandemics
  • Pneumonia, Viral / drug therapy*
  • Research Design
  • SARS-CoV-2

Substances

  • Hydroxychloroquine
  • Azithromycin