Azithromycin in Coronavirus Disease-19: What We Know?

Authors

  • Ashok Agrawal Cadila Pharmaceuticals

DOI:

https://doi.org/10.3889/oamjms.2020.4843

Keywords:

Coronavirus disease-19, Azithromycin, Hydroxychloroquine

Abstract

Azithromycin (AZM) is a broad-spectrum antibiotic with anti-inflammatory and immunomodulatory properties. It is particularly used in chronic lung diseases including chronic obstructive pulmonary disease, asthma, interstitial lung diseases, bronchiectasis, and cystic fibrosis. AZM has not approved for the treatment of viral infections, but some study supported its antiviral activity. Recently, few studies are emphasized used AZM in combination with chloroquine/hydroxychloroquine for the treatment of novel coronavirus disease-2019 (COVID-19). The present review highlighted uses, dosage, and adverse effects of AZM in COVID-19 based on available literature.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Lai CC, Shih TP, Ko WC, Tang HJ, Hsueh PR. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. Int J Antimicrob Agents. 2020;55(3):105924. https:// doi.org/10.1016/j.ijantimicag.2020.105924 PMid:32081636

Wang LS, Wang YR, Ye DW, Liu QQ. A review of the 2019 novel coronavirus (COVID-19) based on current evidence. Int J Antimicrob Agents. 2020;2020:105948. PMid:32201353

WHO Director-general’s Opening Remarks at the Media Briefing on COVID-19. Available from: https://www.who.int/dg/speeches/ detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-COVID-19-11-march-2020. [Last accessed on 2020 Mar 11]. https://doi.org/10.1093/ww/9780199540884.013. u20123

Guan W, Ni Z, Hu Y, Liang W, Ou C, He J, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382:1708-20.

Inciardi RM, Lupi L, Zaccone G, Italia L, Raffo M, Tomasoni D, et al. Cardiac involvement in a patient with coronavirus disease 2019 (COVID-19). JAMA Cardiol. 2020. https://doi.org/10.1001/ jamacardio.2020.1096 PMid:32219357

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506. https://doi. org/10.1016/s0140-6736(20)30183-5 PMid:31986264

Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: Summary of a report of 72 314 cases from the Chinese center for disease control and prevention. JAMA. 2020; 323(13):1239- 1242. https://doi.org/10.1001/jama.2020.2648 PMid:32091533

Dayer MR. Old drugs for newly emerging viral disease, COVID- 19: Bioinformatic Prospective; 2003. https://www.arxiv.org/ftp/ arxiv/papers/2003/2003.04524.pdf. [Last accessed on 2020 Apr 01]. https://doi.org/10.14744/iacapaparxiv.2020.20001

Rapp RP. Pharmacokinetics and pharmacodynamics of intravenous and oral azithromycin: Enhanced tissue activity and minimal drug interactions. Ann Pharmacother. 1998;32(7- 8):785-93. https://doi.org/10.1345/aph.17299 PMid:9681095

Liu P, Allaudeen H, Chandra R, Phillips K, Jungnik A, Breen JD, et al. Comparative pharmacokinetics of azithromycin in serum and white blood cells of healthy subjects receiving a single-dose extended-release regimen versus a 3-day immediate-release regimen. Antimicrob Agents Chemother. 2007;51(1):103-9. https://doi.org/10.1128/aac.00852-06 PMid:17060516

Feola DJ, Garvy BA, Cory TJ, Birket SE, Hoy H, Hayes D Jr., et al. Azithromycin alters macrophage phenotype and pulmonary compartmentalization during lung infection with Pseudomonas. Antimicrob Agents Chemother. 2010;54(6):2437-47. https://doi. org/10.1128/aac.01424-09 PMid:20231397

Li H, Liu DH, Chen LL, Zhao Q, Yu YZ, Ding JJ, et al. Meta-analysis of the adverse effects of long-term azithromycin use in patients with chronic lung diseases. Antimicrob Agents Chemother. 2014;58(1):511-7. https://doi.org/10.1128/ aac.02067-13 PMid:24189261

Min JY, Jang YJ. Macrolide therapy in respiratory viral infections. Mediators Inflamm. 2012;2012:649570. PMid:22719178

Tran DH, Sugamata R, Hirose T, Suzuki S, Noguchi Y, Sugawara A, et al. Azithromycin, a 15-membered macrolide antibiotics, inhibits influenza A(H1N1) pdm09 virus infection by interfering with virus internalization process. J Antibiot. 2019;72:759-68. https://doi.org/10.1038/s41429-019-0204-x

Bosseboeuf E, Aubry M, Nhan T, Pina JJ, Rolain JM, Raoult D, et al. Azithromycin inhibits the replication zika virus. J Antivir Antietrovir. 2018;10(1):6-11. https://doi. org/10.4172/1948-5964.1000173

Madrid PB, Panchal RG, Warren TK, Shurtleff AC, Endsley AN, Green CE, et al. Evaluation of Ebola virus inhibitors for drug repurposing. ACS Infect Dis. 2015;1(7):317-26. https://doi. org/10.1021/acsinfecdis.5b00030 PMid:27622822

Menzel M, Akbarshahi H, Bjermer L, Uller L. Azithromycin induces anti-viral effects in cultured bronchial epithelial cells from COPD patients. Sci Rep 2016;6:28698. https://doi. org/10.1038/srep28698

PMid:27350308

Sandeep S, McGregor K. Energetics based modeling of hydroxychloroquine and azithromycin binding to the SARS-CoV-2 spike (S) protein-ACE2 complex. ChemRxiv. 2020;2020. https://doi.org/10.26434/chemrxiv.12015792.v2

Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-9. https://doi.org/10.1001/jama.2020.1585

Gautret P, Lagier JC, Parola P, Hoang VT, Meddeb L, Mailhe M, et al. Hydroxychloroquine and azithromycin as a treatment of COVID-19: Results of an open-label non-randomized clinical trial. Int J Antimicrob Agents. 2020;2020:105949. https://doi. org/10.1016/j.ijantimicag.2020.105949

Gautret P, Lagier JC, Parola P, Hoang VT, Meddeb L, Sevestre J, et al. Clinical and microbiological effect of a combination of hydroxychloroquine and azithromycin in 80 COVID-19 patients with at least a six-day follow up: A pilot observational study. Travel Med Infect Dis. 2020;34:101663. https://doi.org/10.1016/j. tmaid.2020.101663 PMid:32289548

Esper RB, Silva RS, Oikawa FT, Castro MM, Razuk-Filho A, Batista PB Jr., et al. Empirical Treatment with Hydroxychloroquine and Azithromycin for Suspected Cases of COVID-19 Followed-up by Telemedicine Dropbox; 2020. Available from: http://www.dropbox.com/s/5qm58cd4fneeci2/2020.04.15%20 journal%20manuscript%20final.pdf?dl=0. [Last accessed on 2020 Apr 20].

Azithromycin Side Effects. Available from: https://www.drugs. com/sfx/azithromycin-side-effects.html. [Last accessed on 2020 Mar 27].

Mick P, Westerberg BD. Sensorineural hearing loss as a probable serious adverse drug reaction associated with low-dose oral azithromycin. J Otolaryngol. 2007;36(5):257-63. https://doi.org/10.2310/7070.2007.0047 PMid:17963663

Ress BD, Gross EM. Irreversible sensorineural hearing loss as a result of azithromycin ototoxicity: A case report. Ann Otol Rhinol Laryngol. 2000;109(4):435-7. https://doi. org/10.1177/000348940010900416 PMid:11201801

Brkljacić N, Gracin S, Prkacin I, Sabljar-Matovinović M, Mrzljak A, Nemet Z. Stevens-Johnson syndrome as an unusual adverse effect of azithromycin. Acta Dermatovenerol Croat. 2006;14(1):40-5. PMid:16603101

Banerjee I, Mondal S, Sen S, Tripathi SK, Banerjee G. Azithromycin-induced rash in a patient of infectious mononucleosis-a case report with review of literature. J Clin Diagn Res. 2014;8(8):HD01-2. https://doi.org/10.7860/ jcdr/2014/9865.4729 PMid:25302218

Gibson PG, Yang IA, Upham JW, Reynolds PN, Hodge S, James AL, et al. Effect of azithromycin on asthma exacerbations and quality of life in adults with persistent uncontrolled asthma (AMAZES): A randomised, double-blind, placebo-controlled trial. Lancet. 2017;390(10095):659-68. https://doi.org/10.1016/ s0140-6736(17)31281-3 PMid:28687413

Lu ZK, Yuan J, Li M, Sutton SS, Rao GA, Jacob S, et al. Cardiac risks associated with antibiotics: Azithromycin and levofloxacin. Expert Opin Drug Saf. 2015;14(2):295-303. https://doi.org/10.1 517/14740338.2015.989210 PMid:25494485

National Institute of Diabetes and Digestive and Kidney Diseases. Bethesda, MD: LiverTox: Clinical and Research Information on Drug-Induced Liver Injury; 2012. Available from: https://www.ncbi.nlm.nih.gov/books/NBK548434. [Last accessed on 2020 Mar 27].

Downloads

Published

2020-06-25

How to Cite

1.
Agrawal A. Azithromycin in Coronavirus Disease-19: What We Know?. Open Access Maced J Med Sci [Internet]. 2020 Jun. 25 [cited 2024 Nov. 21];8(T1):92-6. Available from: https://oamjms.eu/index.php/mjms/article/view/4843