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DHSC: Azithromycin and doxycycline should not be used to treat Covid-19


By Isabel Shaw
Reporter

01 Feb 2021

Pharmacy teams and other primary and secondary care staff have been told not to use the antibiotics azithromycin or doxycycline to treat confirmed or suspected Covid-19 cases.

In a Covid-19 therapeutic alert issued on 28 January, the Department of Health and Social Care (DHSC) told NHS acute trusts to ensure all frontline medical, nursing, clinical and pharmacy teams were aware of the updated UK-wide recommendation that azithromycin should not be used in the management of Covid-19 in hospitalised patients.

The alert added that general practices must also ensure their local primary care team is aware that antimicrobials should no longer be used in the primary management of Covid-19 infection – unless there are other licensed indications for which its use remains appropriate.

‘Azithromycin or doxycycline may otherwise continue to be prescribed within the licensed indications (below), within NICE and other associated guidelines,’ it said.

The alert said the drugs may still be used for the treatment of other conditions such as acute bacterial sinusitis, acute bacterial otitis media, pharyngitis, tonsillitis, acute exacerbation of chronic bronchitis, community-acquired pneumonia, skin and soft tissue infections, uncomplicated Chlamydia trachomatis urethritis and cervicitis.

This comes after researchers in the Oxford University PRINCIPLE trial found the two drugs were ‘not generally effective’ as a treatment for suspected Covid-19.

The study is investigating the effectiveness of the antibiotics as potential therapies available in primary care that could potentially speed up the recovery of Covid patients and prevent hospital admission.

However, last week researchers concluded ‘neither treatment reduces the time taken for people to first report that they feel recovered sufficiently to achieve meaningful clinical benefit’.

An inhaler – budesonide – is the only drug which currently remains part of the study, after hydroxychloroquine was also suspended in June.

The RECOVERY trial, another study testing a range of potential treatments for Covid-19, also reported in December that it had found no significant clinical benefit of either oral or intravenous azithromycin in patients hospitalised with Covid-19.


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