Azithromycin is effective against susceptible bacteria causing:
Zithromax, Zithromax Tri-Pak, Zithromax Z-Pak, Zmax are the brand names available for azithromycin in the US.
Though azithromycin is an antibiotic and thus ineffective alone against viruses, some clinicians have seen limited success in COVID-19 coronavirus disease patients when adding it to chloroquine (Aralen) and/or hydroxycholoroquine (Plaquenil) in the sickest patients.
As of March 30, 2020, there is little solid evidence for this drug combination’s effectiveness in general against COVID-19, however.
The initial COVID-19 data about azithromycin came from just a few patients in an observational “open label” study, which makes it difficult to isolate variables and say whether a particular drug is working.
Chloroquine and hydroxychloroquine are decades-old malaria drugs French doctors tested on coronavirus patients. Six patients in the tiny study of about 20 happened to also be on azithromycin for other conditions while also being administered the malaria drugs. All six patients recovered.
Researchers are still testing the malaria drugs and their combination with azithromycin to fight coronavirus.
As of March 30, 2020 available study results on malaria drugs’ effectivness against COVID-19 were mixed, but a French study of 80 patients published that day in the International Journal of Antimicrobial Agents showed encouraging results for both the effectiveness of the malaria drugs and for the addition of azithromycin to the drug cocktail.
The FDA has released both malaria drugs for emergency use in COVID-19, despite the dearth of evidence.
The most common side effects of azithromycin are:
Other possible side effects of azithromycin include:
Possible serious side effects of azithromycin include:
Antibiotics can alter the normal bacteria in the colon and encourage overgrowth of some bacteria such as Clostridium difficile, which causes inflammation of the colon (pseudomembranous colitis). Patients who develop signs of pseudomembranous colitis after starting azithromycin (diarrhea, fever, abdominal pain, and possibly shock) should contact their physician immediately.
Medically Reviewed on 3/30/2020
FDA Prescribing Information
“Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial”
Philippe Gautret, et al
International Journal of Antimicrobial Agents
Some data on COVID-19 use from Aileen Chi, Pharm. D., of Dova Pharmaceuticals