• Azithromycin is used for the treatment of COVID-19 due to its antibacterial, anti-inflammatory, and antiviral properties. 
• There is a lack of randomized data in mild-to-moderate disease. 

Aim-

A study assessed the effectiveness of azithromycin in reducing hospital admission in patients with mild-to-moderate COVID-19.

Design-

It was a prospective, open-label, randomized superiority trial conducted at 19 hospitals in the UK. 

The patients aged >/= 18 years presenting to hospitals with clinically diagnosed, highly probable or confirmed COVID-19 infection, with fewer than 14 days of symptoms, considered suitable for initial ambulatory management, were enrolled for the study. 

Study subjects were randomly assigned to receive azithromycin (500 mg once daily orally for 14 days) plus standard care or standard care alone. 

Primary outcome-

The outcome of death or hospital admission from any cause over 28 days from randomization was observed. 

Assessment of the primary and safety outcomes was performed according to the intention-to-treat principle. 

Findings-

Implications of all the available evidence

Compiling all the available data together, no evidence describes azithromycin to reduce hospital admission, respiratory failure, or death compared with standard care, both in early disease in the community, and those admitted to hospital with severe disease, and even in those with moderate disease managed on an ambulatory pathway.

[One of the most read articles]

Reference-

Hinks TSC, Cureton L, Knight R, Wang A, Cane JL, Barber VS, Black J, Dutton SJ, Melhorn J, Jabeen M, Moss P, Garlapati R, Baron T, Johnson G, Cantle F, Clarke D, Elkhodair S, Underwood J, Lasserson D, Pavord ID, Morgan S, Richards D. Azithromycin versus standard care in patients with mild-to-moderate COVID-19 (ATOMIC2): an open-label, randomised trial.Lancet Respir Med. 2021 Jul 9;S2213-2600(21)00263-0.