Two common antibiotics are found to be ineffective against COVID-19

A UK-wide study has shown that two commonly prescribed antibiotics, azithromycin and doxycycline, provide no benefit to patients who are more than 50 years old and being treated for COVID-19 at home. 

Led by the University of Oxford and coordinated in Wales through Health and Care Research Wales, PRINCIPLE (Platform Randomised trial of INterventions against COVID-19 In older peoPLE) is a clinical study from the University of Oxford to find COVID-19 treatments for the over-50s, which can be taken at home.

After reviewing interim analyses of both the azithromycin and doxycycline data, the independent Trial Steering Committee advised the trial investigators, who concluded that there is no beneficial effect in patients aged over 50 who are treated with either antibiotic at home in the early stages of COVID-19. 

Professor Chris Butler, Co-Lead of the PRINCIPLE trial at the University of Oxford and a GP based in Cynon Vale Medical Practice in Mountain Ash, said:

“While we are completing the analysis of the full range of study outcomes, and in different patient groups, our findings show that a three-day course of azithromycin or a seven-day course of doxycycline has no important clinical benefit in terms of the time taken to feeling recovered, and so will not help most patients with COVID-19 in the early stages their illness.

“The PRINCIPLE trial has grown into a UK-wide community collaboration to find effective treatments for COVID-19 that can be used in the community. Treatments that can speed recovery and prevent hospitalisations are urgently needed worldwide.”

Dr Nicola Williams, Director of Support and Delivery at Health and Care Research Wales, which is nationally co-ordinating research and study-set up in Wales, said:

“It is just as important to highlight which treatments for COVID-19 don’t work as well as those that do. The interim results from this trial give clinicians valuable evidence to inform their treatment of patients with COVID-19 in the community, ensuring antibiotics aren’t prescribed where they aren’t needed.”

This trial is open across Wales to people aged over 50 with certain underlying health conditions, or anyone aged over 65. Those with coronavirus symptoms, or a confirmed COVID-19 infection, can join easily from home online, over the telephone or via their GP practice from anywhere in Wales. 

This trial is one of three national platform trials for COVID-19 treatments and complements RECOVERY and REMAP-CAP, also taking place in Wales. 

Find out more about COVID-19 research in Wales.

PRINCIPLE is led from the Primary Care Clinical Trials Unit at the University of Oxford’s Nuffield Department of Primary Care Health Sciences. PRINCIPLE is supported by a vast network of care homes, pharmacies, NHS 111 Hubs, hospitals, and 1,016 GP practices across England, Wales, Scotland and Northern Ireland. The trial is integrated with the Oxford-RCGP Research and Surveillance Centre and works closely with the NIHR Clinical Research Network, NHS DigiTrials, Public Health England, Health and Care Research Wales, NHS Research Scotland and the Health and Social Care Board in Northern Ireland. PRINCIPLE continues to investigate the effects of treatment in the community with inhaled budesonide, an inhaled corticosteroid, which is also anti-inflammatory, and potentially antiviral.

PRINCIPLE is funded by UK Research and Innovation and the Department of Health and Social Care through the National Institute for Health Research as part of the UK Government’s rapid research response fund.