COVID-19 Therapeutic Alert - Antimicrobials (azithromycin and doxycycline) Not Beneficial in the Management of COVID-19 (SARS-CoV-2) Positive Patients

Azithromycin and doxycycline should NOT be used in the management of confirmed or suspected COVID-19 infection within primary care, and azithromycin should not be used in hospitalised patients, unless there are additional indications for which use remains appropriate.

SPS commentary:

The supporting evidence for these recommendations is discussed in the Alert. In summary, results from an interim analysis of the PRINCIPLE platform trial in primary care show that neither azithromycin nor doxycycline offers any clinically meaningful benefit over standard of care in patients aged >50 treated at home in the early stages of Covid-19. Additionally, results from the RECOVERY platform trial showed no significant clinical benefit of either oral or intravenous azithromycin in patients hospitalised with COVID-19.

The alert contains actions for NHS trusts/health/boards/hospitals and general practices.


Medicines and Healthcare products Regulatory Agency