ReviewBMJ open respiratory research2021
Rationale for azithromycin in COVID-19: an overview of existing evidence.
Review in BMJ open respiratory research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
33 citing papers in PubMed, 2 syntheses or guidelines pooled it, 74 citations in OpenAlex.
- Azithromycin in patients with COVID-19: a systematic review and meta-analysis.The Journal of antimicrobial chemotherapy · 2022Pooled it
- Efficacy and safety of azithromycin in Covid-19 patients: A systematic review and meta-analysis of randomized clinical trials.Reviews in medical virology · 2022Pooled it
- The Combination of Nirmatrelvir and Ivermectin Exerts Strongly Synergistic Antiviral and Anti-Inflammatory Effects Against Murine Coronavirus Infection of Macrophages.International journal of molecular sciences · 2026Article
- Article
- Antibiotic usage patterns in COVID-19 patients in five tertiary hospitals from Bangladesh: A countrywide picture.IJID regions · 2024Article
- Antibiotic utilization patterns in Tanzania: a retrospective longitudinal study comparing pre- and intra-COVID-19 pandemic era using Tanzania Medicines and Medical Devices Authority data.JAC-antimicrobial resistance · 2024Article
- Identification of Pyrazole Derivatives of Usnic Acid as Novel Inhibitor of SARS-CoV-2 Main Protease Through Virtual Screening Approaches.Molecular biotechnology · 2024Article
- Use of antibiotics in Paediatric Primary Health Care before and during the COVID-19 pandemic.Enfermedades infecciosas y microbiologia clinica (English ed.) · 2023Observational
- A Retrospective Assessment of Sputum Samples and Antimicrobial Resistance in COVID-19 Patients.Pathogens (Basel, Switzerland) · 2023Article
- Drug prescription patterns and their association with mortality and hospitalization duration in COVID-19 patients: insights from big data.Frontiers in public health · 2023Article
- A Review of Antibiotic Efficacy in COVID-19 Control.Journal of immunology research · 2023Review
- A Comprehensive Review on the Efficacy of Several Pharmacologic Agents for the Treatment of COVID-19.Life (Basel, Switzerland) · 2022Review
- Factors Associated with Self-Medication during the COVID-19 Pandemic: A Cross-Sectional Study in Pakistan.Tropical medicine and infectious disease · 2022Article
- COVID-19 hospitalization with later long COVID in a person with Down syndrome.Clinical case reports · 2022Article
- Review
- Gut microbiota and COVID-19: An intriguing pediatric perspective.World journal of clinical cases · 2022Review
- Azithromycin through the Lens of the COVID-19 Treatment.Antibiotics (Basel, Switzerland) · 2022Review
- [Use of antibiotics in Paediatric Primary Health Care before and during the COVID-19 pandemic].Enfermedades infecciosas y microbiologia clinica · 2022Article
- Empiric Antibiotics in COVID 19: A Narrative Review.Cureus · 2022Review
- COVID-19 Disease in Syrian Patients With Cancer: Clinical Manifestations, Laboratory Findings, Treatment, and Outcomes.JCO global oncology · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Azithromycin has rapidly been adopted as a repurposed drug for the treatment of COVID-19, despite the lack of high-quality evidence. In this review, we critically appraise the current pharmacological, preclinical and clinical data of azithromycin for treating COVID-19. Interest in azithromycin has been fuelled by favourable treatment outcomes in other viral pneumonias, a documented antiviral effect on SARS-CoV-2 in vitro and uncontrolled case series early in the pandemic. Its antiviral effects presumably result from interfering with receptor mediated binding, viral lysosomal escape, intracellular cell-signalling pathways and enhancing type I and III interferon expression. Its immunomodulatory effects may mitigate excessive inflammation and benefit tissue repair. Currently, in vivo reports on azithromycin in COVID-19 are conflicting and do not endorse its widespread use outside of clinical trials. They are, however, mostly retrospective and therefore inherently biased. The effect size of azithromycin may depend on when it is started. Also, extended follow-up is needed to assess benefits in the recovery phase. Safety data warrant monitoring of drug-drug interactions and subsequent cardiac adverse events, especially with hydroxychloroquine. More prospective data of large randomised controlled studies are expected and much-needed. Uniform reporting of results should be strongly encouraged to facilitate data pooling with the many ongoing initiatives.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.