Potential Toxicity of The Combination of Hydroxychloroquine and Azithromycin for Covid-19 Therapy: Literature Review
Abstract
One of the therapies often used for COVID-19 patients is a combination of Hydroxychloroquine and Azithromycin. Although only short-term treatment, Hydroxychloroquine and Azithromycin may increase the risks of QTc and TdP intervals prolongation. This literature review aims to determine the potential toxicity of the combination of Hydroxychloroquine and Azithromycin for COVID-19 therapy. This study involved the PubMed, NCBI, Science Direct, NIH MEDLINE, Google Scholar and ProQuest databases. The 24 articles collected were then selected. Finally, 15 articles were found feasible for references in a literature review. The study results showed that combined Hydroxychloroquine and Azithromycin in COVID-19 therapy could increase the risk of QTc and TdP waves prolongation. It can be concluded that the combination of Hydroxychloroquine and Azithromycin carried the risk of prolongation of QTc and TdP waves in the heart rhythm cycle. There is a need for monitoring and/or recommendation regarding instructions for the use of combination therapy of the two types of drugs among patients with COVID-19.
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References
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Yendrapalli U, Ali H, Green JL, Edwards J. Effects of cardiac toxicity of combination therapy with hydroxychloroquine and azithromycin in COVID-19 patients. Journal of Infection and Public Health. 2021 Nov 1;14(11):1668-70.
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Eftekhar SP, Kazemi S, Barary M, Javanian M, Ebrahimpour S, Ziaei N. Effect of hydroxychloroquine and azithromycin on QT interval prolongation and other cardiac arrhythmias in COVID-19 confirmed patients. Cardiovascular Therapeutics. 2021 Feb 27;2021:1-7.
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Li C, Cheng G. Will hydroxychloroquine still be a game-changer for COVID-19 by combining azithromycin?. Frontiers in Immunology. 2020 Aug 7;11:1969.
Huang HD, Jneid H, Aziz M, Ravi V, Sharma PS, Larsen T, Chatterjee N, Saour B, Aziz Z, Nayak H, Trohman RG. Safety and effectiveness of hydroxychloroquine and azithromycin combination therapy for treatment of hospitalized patients with COVID-19: a Propensity-Matched study. Cardiology and Therapy. 2020 Dec;9:523-34.
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O'Connell TF, Bradley CJ, Abbas AE, Williamson BD, Rusia A, Tawney AM, Gaines R, Schott J, Dmitrienko A, Haines DE. Hydroxychloroquine/azithromycin therapy and QT prolongation in hospitalized patients with COVID-19. Clinical Electrophysiology. 2021 Jan 1;7(1):16-25.
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Tuncer T, Karaci M, Boga A, Durmaz H, Guven S. QT interval evaluation associated with the use of hydroxychloroquine with combined use of azithromycin among hospitalised children positive for coronavirus disease 2019. Cardiology in the Young. 2020 Oct;30(10):1482-5.
Ramireddy A, Chugh H, Reinier K, Ebinger J, Park E, Thompson M, Cingolani E, Cheng S, Marban E, Albert CM, Chugh SS. Experience with hydroxychloroquine and azithromycin in the coronavirus disease 2019 pandemic: implications for QT interval monitoring. Journal of the American Heart Association. 2020 Jun 16;9(12):e017144.
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