Abstract
The coronavirus disease 2019 (COVID-19), caused by infection with severe acute respiratory syndrome coronavirus 2, has recently emerged worldwide. In this context, there is an urgent need to identify safe and effective therapeutic strategies for treatment of such highly contagious disease. We recently reported promising results of combining hydroxychloroquine and azithromycin as an early treatment option. Although ongoing clinical trials are challenging the efficacy of this combination, many clinicians claim the authorization to or have already begun to use it to treat COVID-19 patients worldwide. The aim of this article is to share pharmacology considerations contributing to the rationale of this combination, and to provide safety information to prevent toxicity and drug–drug interactions, based on available evidence.
Highlights
The coronavirus disease 2019 (COVID-19), caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has recently emerged worldwide
Hydroxychloroquine, which is better tolerated than chloroquine in humans, exhibits both an antiviral activity against SARS-CoV-2 in vitro and strong immunomodulatory capacities that can be useful in COVID-19.2 Potential mechanisms of action of hydroxychloroquine in COVID-19 disease have been reviewed recently.[3]
In a single-center nonrandomized trial conducted at IHU-Mediterranee-InfectionAPHM in which 24 positive COVID-19 patients were treated with hydroxychloroquine 600 mg per day for 10 days and antibiotic therapy if necessary, 70% of patients who received hydroxychloroquine were PCR negative at day 6, compared with
Summary
The coronavirus disease 2019 (COVID-19), caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has recently emerged worldwide In this context, there is an urgent need to identify safe and effective therapeutic strategies for treatment of this new and highly contagious disease. In COVID-19 patients, the transition from the first symptoms of this viral infection to acute respiratory distress syndrome is likely due to uncontrolled cytokine release.[1] Hydroxychloroquine, which is better tolerated than chloroquine in humans, exhibits both an antiviral activity against SARS-CoV-2 in vitro and strong immunomodulatory capacities that can be useful in COVID-19.2 Potential mechanisms of action of hydroxychloroquine in COVID-19 disease have been reviewed recently.[3] In a single-center nonrandomized trial conducted at IHU-Mediterranee-InfectionAPHM in which 24 positive COVID-19 patients were treated with hydroxychloroquine 600 mg per day for 10 days and antibiotic therapy if necessary (amoxicillin–clavulanic acid or azithromycin), 70% of patients who received hydroxychloroquine were PCR negative at day 6, compared with. Pragmatic Factorial Trial of Hydroxychloroquine, Azithromycin, or Both for Treatment of Severe SARS-CoV-2 Infection
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