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The severity of COVID-19 has resulted in a global rush to find the right antiviral treatment to conquer the pandemic and to treat patients. This requires reliable studies to support treatment. In a recently published study by Gautret et al. the authors concluded that hydroxychloroquine monotherapy and hydroxychloroquine in combination with azithromycin reduced viral load. However, this trial has several major methodological issues, including the design, outcome measure and the statistical analyses. In this paper we discuss the background, clinical evidence, pharmacology and methodological issues related to this clinical trial. We understand the rush to release results, however in case conclusions are far reaching the evidence needs to be robust.

Original publication





International journal of antimicrobial agents

Publication Date





Department of Medical Microbiology & Radboudumc Center for Infectious Diseases, the Netherlands.


Humans, Pneumonia, Viral, Coronavirus Infections, Azithromycin, Hydroxychloroquine, Drug Therapy, Combination, Research Design, Clinical Trials as Topic, Pandemics, Betacoronavirus, Outcome Assessment, Health Care