What antibiotics kill COVID-19 (coronavirus)?

• There are no antibiotics that kill the SARS-CoV-2 virus, the virus which causes COVID-19.
• Antibiotics work on bacteria to kill or slow their growth.
• COVID-19 is caused by a virus so you need an antiviral medicine to slow the virus's development.

Click here for information on COVID-19: Treatments and Vaccines

Azithromcyin and COVID-19

Azithromycin (Zithromax) is a macrolide antibiotic that was being investigated in clinical trials as a potential treatment for people with COVID-19, at the beginning of the COVID-19 pandemic. It was often trialed in conjunction with hydroxychloroquine. Hydroxychloroquine is not recommended for treatment of COVID-19 by the National Institutes of Health (NIH).

Scientists started studying Azithromycin, even though it was an antibiotic, as it was thought to also have antiviral effects, anti-inflammatory activity, be able to change the immune response and may work well with other antiviral treatments. In in vitro laboratory studies azithromycin has demonstrated antiviral activity against Zika virus and against rhinoviruses, which cause the common cold.

Results of many clinical trials show that azithromycin did not improve patients' health, when compared to standard COVID-19 treatments.

• The results of both the COALITION II Trial (NCT04321278) and the RECOVERY Trial (NCT04381936) showed that when treating hospitalized COVID-19 patients the addition of using azithromycin was not any better than just using standard care alone.
• The PRINCIPLE clinical trial, studied treating non hospitalized COVID-19 patients (outpatients) with azithromycin and results showed that azithromycin did not provide benefits in terms of reducing time to recovery or risk of hospitalization, when compared to standard COVID-19 treatment.

The NIH recommends against the use of antibacterial therapy (e.g., azithromycin, doxycycline) for non hospitalized COVID-19 patients unless there is another medical reason to prescribe an antibiotic.

The World Health Organisation (WHO) does not recommend azithromycin or other antibiotics to be used for COVID-19 in the 'Guideline Therapeutics and COVID-19: living guideline'.

COVID-19 Pneumonia and Antibiotics

Part of the COVID-19 illness is viral lung infection (viral pneumonia). A small number of viral pneumonias can also develop a bacterial infection within the lung.

• The addition of the bacterial infection on top of the viral infection is called a secondary bacterial infection.
• If there is a secondary bacterial infection it may need to be treated with an antibiotic.
• If there is no bacterial infection, then antibiotics are not needed.

If treatment is required for a secondary bacterial infection then a range of antibiotics can be used such as:

• penicillins (ampicillin plus sulbactam [Unasyn],
• piperacillin plus tazobactam [Zosyn]),
• cephalosporins (ceftriaxone [Rocephin]Cefepime [Maxipime]),
• aminoglycosides (tobramycin)
• glycopeptides (vancomycin [Vancocin HCL])

Often a combination of two different antibiotics is used.

Click here for more information on: COVID-19: Symptoms, Prevention and Risks

Bottom Line:

• Antibiotics do not kill the SARS-CoV-2 virus, the virus causes COVID-19.
• Antibiotics are used to treat bacterial infections.
• Azithromycin and other antibiotics are not recommended to treat COVID-19, unless they are being prescribed an antibiotic for a bacterial infection the patient currently has as well as COVID-19.