Infectious Disease Organization Advises Against Hydroxychloroquine

The Infectious Diseases Society of America (IDSA) announced on Friday it had revised its guidelines recommending against the use of either hydroxychloroquine alone or in combination with azithromycin in the hospital setting for coronavirus 2019 (COVID-19).

“In assessing the current state of the literature, IDSA’s expert guidelines panel concluded that higher certainty benefits (e.g., mortality reduction) for the use of these treatments are now highly unlikely even if additional high quality data would become available,” in a statement written by the organization. “Previously, IDSA recommended that hydroxychloroquine be used only in the context of a clinical trial, and that hydroxychloroquine plus azithromycin not be used outside the context of a clinical trial.”

This decision comes on the heels of another organization, the American College of Physicians, retiring its living, rapid practice regarding the use of chloroquine and hydroxychloroquine, with or without azithromycin, as either prophylaxis or treatment.

In the beginning of the pandemic, this medication was being touted by some as an efficacious treatment for COVID-19, and the number of patients in the US who received prescriptions for hydroxychloroquine, chloroquine, and azithromycin shot up dramatically.

And the US Food and Drug Administration (FDA) granted an Emergency Use Authorization (EUA) for hydroxychloroquine and chloroquine back in the spring.

Since then, weak data and mixed results have resulted in the federal government walking back its usage. The FDA reversed course and revoked the EUA in June.

Contagion Editor-in-Chief Jason Gallagher PHARMD, FCCP, FIDP, FIDSA, BCPS weighed-in about hydroxychloroquine. “Unfortunately, the early excitement about hydroxychloroquine has not been warranted, and the time has come to abandon it and move on to explore other possible therapies,” Gallagher wrote. “At this point the threshold for new data evaluating hydroxychloroquine must be raised to prospective, randomized, blinded studies designed to remove the bias that non-randomized studies inherently create, while we need to revert to using retrospective studies for the hypothesis-generation for which they are intended.”