Some people consider treating coronavirus patients with a combination of the malaria drug hydroxychloroquine and the antibiotic azithromycin.
But in a new study, researchers advise caution because both medications can increase the risk of dangerous abnormal heart rhythms.
The research was conducted by cardiologists from Oregon Health & Science University and Indiana University.
The team recommends clinicians who treat COVID-19 patients with the malaria-antibiotic drug combination also consider monitoring those patients for ventricular arrhythmia, which involves the lower heart chambers beating quickly and irregularly and can lead to cardiac arrest.
There are hundreds of drugs that can increase the risk for cardiac arrest, but using two together in patients who are already at risk or critically ill could increase that risk further, according to the team.
The researchers recommend clinicians who treat COVID-19 patients with the drug combination also monitor patients for dangerous arrhythmias.
However, they acknowledge limited resources could make monitoring a challenge.
More clinical outcome data supporting the benefit or harm of these medications are needed.
The team advocates for a cautious approach in using the combination of hydroxychloroquine and azithromycin.
Any medications that increase the risk of cardiac risk require consideration of both risks and benefits, and right now scientists do not have evidence that benefits outweigh risks for use of hydroxychloroquine or chloroquine.
Until doctors have more information, patients should be monitored for arrhythmias during any use of these medications, alone or in combination, unless the risk of infection for health care workers or limitations in the use of personal protective equipment are prohibitive.
The lead author of the study is Eric Stecker, M.D., M.P.H., an associate professor of medicine.
The study is published in the American College of Cardiology publication Cardiology Magazine.
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