Advances in Infectious Diseases & Therapy

Open Access


Azithromycin Treatment in COVID-19 is Not Associated with Clinical Course Shortening, But it Is Associated with a Reduction in Mortality. A Case Control-Study Paired By Sex, Age Group, Chronic Diseases and Severity

Jose Luis Turabian

Background: Azithromycin (AZT) has been proposed as a treatment for COVID-19 on the basis of its immunomodulatory actions.

Objective: To assess the association between exposure to AZT in patients with COVID-19, both admitted to the hospital and treated as outpatients, with respect to the duration of their clinical course and mortality.

Methodology: An observational and retrospective case control-study paired by sex, age group (> and = <65 years), presence or absence of chronic diseases, and severity (presence or absence of pneumonia) was conducted March 15, 2020 to March 15, 2021, in a general medicine office in Toledo, Spain.

Results: 19 cases and 19 controls were included. 26% of the cases and 42% of the controls had a positive clinical result (improvement or clinical cure before 13 days of the onset of the disease) (Fisher exact test = 0.1051; Paired OR = 0.4545 (Confidence intervals at 95%: 0.1579, 1.308). In the 19 cases there were no deaths vs. 2 deaths in the control group (Fisher exact test = 0.0001; paired OR = 0.1053 (Confidence intervals at 95 % = 0.02452, 0.4519).

Conclusions: In the context of general medicine in Toledo (Spain), AZT did not shorten the duration of clinical symptoms, but it was shown to be a protective factor against mortality. Due to the limitations of the study design, the results should be considered with caution and the use of AZT in COVID-19 should be probably restricted, to date, to patients in whom there is an antimicrobial indication.

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