Should Azithromycin (Z-pack) Be Prescribed For Covid-19 Infections?

Written by Dr. Ryner Lai
January 27, 2021

The surge of Covid-19 infections sweeping across the globe has resulted in a lot of fear and anxiety. Many of us have friends and family members who have contracted the virus; some of us have contracted the virus ourselves. 


Covid-19 has claimed millions of lives and put severe pressure on healthcare systems around the globe. Scientists are working on two fronts to combat this deadly disease. The first is to create a vaccine. The second is to discover the best drug cocktail to treat severe manifestations of this disease. 


One medication that was looked at closely to study its efficacy in treating Covid-19 is azithromycin. Let’s have a look at this medication and see if it is useful to treat Covid-19. 


What Is Azithromycin? 

Azithromycin is a commonly prescribed antibiotic. It is often prescribed for diseases caused by bacteria that can cause ear infections, pneumonia, upper respiratory infections, throat infections, and STDs. 


It belongs to a class of antibiotics known as macrolides. Different antibiotics have different mechanisms of action in fighting bacteria. Macrolides like azithromycin work by interfering with bacterial protein synthesis. When bacteria cannot synthesize protein, they will die, thus helping the body to fight and get rid of the infection. 


Azithromycin and Covid-19

Antibiotics are not used to treat viral infections. The public sometimes assumes that bacterias and viruses are one and the same. In fact, they are two different types of microorganisms. Antibiotics, no matter how strong, are ineffective in treating diseases that have a viral origin. 


Azithromycin, however, was initially considered to be a potential drug in treating Covid-19 due to its anti-inflammatory properties. Inflammation occurs in patients who experience severe symptoms of the disease. Therefore, medical professionals carried out a clinical trial to study its efficacy in treating severe symptoms of Covid-19. 


However, the preliminary analysis of data from a UK randomized controlled trial found that azithromycin offers no clinical benefit in treating Covid-19. This means that a patient who has contracted Covid-19 will not experience any relief in his or her symptoms by taking this medication. Instead, azithromycin should only be prescribed if there is evidence of bacterial infection. It can also be prescribed in severe Covid-19 cases in which bacterial causes of X-ray lung findings cannot be excluded (i.e. pneumonia).



Azithromycin should not be routinely prescribed for Covid-19 infections because it does not help in fighting the disease. Instead, it may actually lead to the development of antibiotic resistance. It can also lead to side effects such as diarrhea, nausea, vomiting, and more. 

If you are experiencing symptoms suggestive of Covid-19, such as fever, dry cough, or fatigue, get tested as soon as possible and isolate yourself from others to avoid spreading the disease. If you experience shortness of breath, go to your nearest emergency department. For milder Covid-19 symptoms, you can arrange for a telemedicine consultation via QuickMD here for advice and treatment.


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