A group of American experts advised doctors not to treat their patients contaminated by the coronavirus by a treatment mixing hydroxychloroquine and azithromycin, promoted in particular by the French doctor Didier Raoult. This dual therapy would involve risks for the heart. 

A group of American experts under the aegis of the National Institutes of Health has formally advised doctors not to treat their patients with coronavirus with the double treatment hydroxychloroquine and azithromycin, because of the risks for the heart.

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"With the exception of the context of clinical trials, the panel (...) recommends not to use the following drugs for the treatment of Covid-19: the combination of hydroxychloroquine and azithromycin, because of the potential toxicities", warns the group in clinical guidelines released Tuesday, also advising against the anti-HIV drug lopinavir / ritonavir.

"No drug has been shown to be safe and effective"

The panel brings together dozens of representatives from the National Institutes of Health, professional organizations of doctors, universities, hospitals and federal agencies. It formulates guidelines for the management of patients with the new coronavirus, based on studies carried out to date. "Currently, no drug has been shown to be safe and effective in treating Covid-19," the panel writes in bold.

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Concerning the taking alone of hydroxychloroquine, without the antibiotic azithromycin, as well as the antiviral remdesivir, the panel explains that there are not yet rigorous studies to allow to decide in one direction or the other . "There is not enough clinical data to recommend or advise against chloroquine or hydroxychloroquine", write the experts of the panel.

"If chloroquine or hydroxychloroquine are used, clinicians should monitor the patient for side effects, including the QTc interval," they warn. This means that these molecules can cause heart rhythm problems in some patients, a known effect because the drug has been used for a long time against malaria.

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A controversial cocktail

Hydroxychloroquine is given in dual therapy with the antibiotic azithromycin in many hospitals around the world, and the cocktail is particularly promoted by the French doctor Didier Raoult. This scientist is very critical of experts arguing that more rigorous clinical trials are needed to find out if it is really this cocktail of molecules that has helped many of his patients to recover from Covid-19. Such trials are in progress. 

US President Donald Trump initially touted this dual therapy as a "gift from heaven", but recently, in the face of controversy and after doctors reported disturbing results, he no longer discussed chloroquine.