NIH panel recommends against use of hydroxychloroquine and azithromycin to treat COVID-19

A panel of experts convened by the U.S. National Institutes of Health (NIH) has issued coronavirus treatment guidelines, recommending against the use of anti-malaria drug hydroxychloroquine in combination with the antibiotic azithromycin outside clinical trials. 

“The combination of hydroxychloroquine and azithromycin was associated with QTc prolongation in patients with COVID-19,” the panel said. QTc prolongation increases the risk of sudden cardiac death. 

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The recommendation comes after President Trump has repeatedly touted the use of the drugs on Twitter and during White House coronavirus task force briefings. 

In a tweet in late March, Trump described the drug combination as having a “real chance to be one of the biggest game changers in the history of medicine.” 

“I think it’s not a bad idea to do it, but that’s up to the doctors,” Trump said on April 1, adding “It’s going to have to be proven. It’s very early.” 

The panel went on to say there was insufficient clinical data to recommend either for or against the use of hydroxychloroquine or chloroquine alone. The drugs have been used to treat malaria and more recently lupus and arthritis. 

“If chloroquine or hydroxychloroquine is used, clinicians should monitor the patient for adverse effects,” the group said.

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The panel, made up of dozens of doctors, pharmacy experts and government researchers and officials, produced the set of guidelines for physicians to use in treating patients infected with COVID-19.

The guidelines go on to recommend against the use of Lopinavir/ritonavir or other HIV protease inhibitors due to negative clinical trial data, and also recommended against using interferon because it appeared to make patients with SARS and MERS worse. 

The panel concluded there was insufficient evidence to recommend any kind of treatment to prevent coronavirus infection, or to stop the progress of symptoms in those who were infectious, as there is not enough data for or against the vast majority of medicines. 

The NIH said the guidelines will be updated as often as new peer-reviewed data is published. 

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