Prestigious medical journal urges outpatient use of hydroxychloroquine regimen for COVID-19

'These medications need to be widely available and promoted immediately for physicians to prescribe,' the American Journal of Epidemiology says.

Updated: May 29, 2020 - 10:53am

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A prestigious medical journal is criticizing news media coverage of hydroxychlorioquine in the battle against coronavirus, saying there is evidence the anti-malarial drug combined with the antibiotic azithromycin helps in the early stages of outpatient treatment.

 

"These medications need to be widely available and promoted immediately for physicians to prescribe," the American Journal of Epidemiology reported in an article published this week that pushed back against claims the regimen has been dangerous or ineffective in all cases.

"Hydroxychloroquine plus azithromycin has been widely misrepresented in both clinical reports and public media, and outpatient trials results are not expected until September," the journal noted, urging medical professionals and the public to recognize there are different stages of the disease that may require different treatments.

The article said the two candidate medications which have been widely reported - remdesivir and hydroxychloroquine plus azithromycin -- need to be looked at differently.  

"Remdesivir has shown mild effectiveness in hospitalized inpatients, but no trials have been registered in outpatients," it said.

Meanwhile, the regimen with hydroxychloroquine has been the subject of five studies, including two controlled clinical trials, that "have demonstrated significant major outpatient treatment efficacy."

The article noted that while there have been some instances of the drug regimen creating heart arrhythmias, the reactions are relatively small compared to those dying from COVID-19.

"Hydroxychloroquine+azithromycin has been used as standard-of-care in more than 300,000 older adults with multicomorbidities, with estimated proportion diagnosed with cardiac arrhythmias attributable to the medications 47/100,000 users, of which estimated mortality is <20%, 9/100,000 users, compared to the 10,000 Americans now dying each week." the journal said.

The most compelling argument, the journal said, is how hydroxycholoroquine plus azithromycin reduces the rate of mortality. 

Below are the percentages of doctors prescribing the hydroxychloroquine plus azithromycin regimen to COVID-19 patients across the globe: 

  • 72% in Spain;
  • 49% in Italy; 
  • 41% in Brazil; 
  • 39% in Mexico; 
  • 28% in France; 
  • 23% in the US; 
  • 17% in Germany; 
  • 16% in Canada;
  • 13% in the UK;

And at four New York hospitals, a recent study found that adding zinc sulfate with hydroxychloroquine and azithromycin significantly cuts both the need for intubation and mortality risks by half, researchers said.

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