CLINICAL OUTCOMES AND ADVERSE DRUG REACTIONS IN COVID-19 PATIENTS TREATED WITH HYDROXYCHLOROQUINE AND AZITHROMYCIN ALONE OR COMBINED
DOI:
https://doi.org/10.11603/ijmmr.2413-6077.2021.1.11814Keywords:
hydroxychloroquine, azithromycin, SARS CoV-2Abstract
Background. Use of Hydroxychloroquine with or without Azithromycin is repurposed in SARS-CoV-2 in the absence of definitive treatment.
Objective. To evaluate the association between the use of Hydroxychloroquine and Azithromycin when given alone or in combination on clinical outcomes and adverse drug reactions among lab confirmed SARS CoV-2 positive patients admitted in a COVID tertiary care hospital of a University Medical college.
Methods. a retrospective observational comparative study was conducted. COVID-19 positive patients admitted in study hospital for management of COVID-19 were enrolled into the study. The patients were categorized into 4 treatment groups based on having received the following treatment during hospitalization: (A) Hydroxychloroquine with Azithromycin, (B) Hydroxychloroquine without Azithromycin (Hydroxychloroquine alone), (C) Azithromycin alone, and (D) Neither drug, defined as no receipt of either Hydroxychloroquine or Azithromycin in the record; other medications may have been dispensed.
Results. 800 patients were enrolled. Mean±Standard deviation of duration of hospital stay (in days) for study Group A was 11.37±7.11, for Group B was 8.37±4.77, for Group C was 18.22 ± 5.69 and for Group D was 6.12±2.97. Mortality in Group A was 29.74%, Group B – 33.16%, Group C – 0% and in Group D – 1.32%.
Conclusion. Among hospitalized patients with COVID-19 treatment, Group C was associated with good clinical outcome. However, the interpretation of these findings may be limited by the observational design.
References
Lai CC, Shih TP, Ko WC, Tang HJ, Hsueh PR. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. Int J Antimicrob Agents 2020 Feb 17:105924.
DOI: 10.1016/j.ijantimicag.2020.105924.
Wang LS, Wang YR, Ye DW, Liu QQ. A review of the 2019 Novel Coronavirus (COVID-19) based on current evidence”. Int J Antimicrob Agents 2020.
David N. Juurlink. Safety considerations with chloroquine, Hydroxychloroquine and Azithromycin in the management of SARS-CoV-2 infection. Canadian Medical Association Journal 2020;192 (17).
Wen Zhang et. al. The use of anti-inflammatory drugs in the treatment of people with severe coronavirus disease 2019 (COVID-19): The Perspectives of clinical immunologists from China. Clinical Immunology 2020; 214: 108393.
Shi et al. An overview of COVID-19. J Zhejiang Univ-Sci B (Biomed & Biotechnol) 2020;21(5):343-60.
Yamauchi K, Shibata Y, Kimura T, Abe S, Inoue S, Osaka D, et al. Azithromycin suppresses interleukin-12p40 expression in lipopolysaccharide and interferon-gamma stimulated macrophages. Int J Biol Sci 2009;5(7):667-78.
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lance 2020; 395(10223):497–506.
DOI: 0.1016/S0140-6736(20) 30183-5.
Silvano Esposito, Silvana Noviello, Pasquale Pagliano. Update on treatment of COVID-19: ongoing studies between promising and disappointing results. Le Infezioni in Medicina 2020; 2:198-211.
Samia Arshad et.al. Treatment with Hydroxychloroquine, Azithromycin, and combination in patients hospitalized with COVID-19. International Journal of Infectious Diseases 2020;97:396-403.
Tran DH, Sugamata R, Hirose T, Suzuki S, Noguchi Y, Sugawara A, et al. Azithromycin, a 15-membered macrolide antibiotic, inhibits influenza A(H1N1) pdm09 virus infection by interfering with virus internalization process. J Antibiot 2019;72 (10):759–68.
DOI:10.1038/s41429-019-0204-x.
Matthieu Million et.al. Early treatment of COVID-19 patients with Hydroxychloroquine and Azithromycin: A retrospective analysis of 1061 cases in Marseille, France. Travel Medicine and Infectious Disease 2020:1-8.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 International Journal of Medicine and Medical Research

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who sent their manuscript to International Journal of Medicine and Medical Research agree to the following terms:
1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License CC-BY-NC that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
2. Authors able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
