Treating COVID19 with Hydroxychloroquine and Azithromycin

I have received many questions about azithromycin and hydroxychloroquine.  These medications have been on the news, and some politicians and reporters are touting them as miracle cures.  At this time, these medications are being used experimentally for treating COVID19, mostly on hospitalized patients with severe disease.  The studies which have been done are small with mixed results.  Hydroxychloroquine and chloroquine are currently being investigated in randomized controlled trials, but at this time, we cannot say with any certainty whether these treatments work.

Azithromycin, chloroquine, and hydroxychloroquine all have anti-inflammatory properties.  Azithromycin is an antibiotic, which means that it is used to treat bacterial infections and has no effect on viruses, including corona viruses.  However, azithromycin is given to patients with certain inflammatory lung conditions to clear up the inflammation.  Hydroxychloroquine and chloroquine are used for treating and preventing malaria, a parasite which attacks red blood cells.  Hydroxychloroquine is also used in treating autoimmune inflammatory conditions such as rheumatoid arthritis and lupus.  Hydroxychloroquine may actually help to prevent the COVID19 virus from entering our cells.

The majority of patients with COVID19 have mild cold symptoms and do not require any special treatment, but certain high-risk individuals develop severe inflammation which affects lung function, sometimes requiring a ventilator.  Azithromycin and hydroxychloroquine have been used together to treat severe cases of COVID19.  Both medications can cause very serious side effects, including a fatal heart arrhythmia.  This particular risk increases when the two medications are taken together; however, hospitalized patients have continuous heart monitoring.  A local hospital was previously treating all COVID19 patients with both azithromycin and hydroxychloroquine and is now only using hydroxychloroquine.  It is unclear whether this change was made due to the complications of taking these medications together or because azithromycin was shown to be ineffective.

At this point, I feel that the risks of taking these medications for prevention or for treating mild cases of COVID19 outweigh any benefits.

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