{"id":176475,"date":"2020-03-20T00:00:00","date_gmt":"2020-03-19T23:00:00","guid":{"rendered":"https:\/\/www.bcfi.be\/covid-19-ne-pas-prescrire-dazithromycine-pour-le-traitement-a-domicile-des-patients-covid-19\/"},"modified":"2026-04-02T19:10:39","modified_gmt":"2026-04-02T17:10:39","slug":"covid-19-ne-pas-prescrire-dazithromycine-pour-le-traitement-a-domicile-des-patients-covid-19","status":"publish","type":"post","link":"https:\/\/h.cbip.be\/fr\/covid-19-ne-pas-prescrire-dazithromycine-pour-le-traitement-a-domicile-des-patients-covid-19\/","title":{"rendered":"COVID-19 : ne pas prescrire d\u2019azithromycine pour le traitement \u00e0 domicile des patients COVID-19"},"content":{"rendered":"<p><strong>Les autorit\u00e9s sanitaires belges et les experts (dont BAPCOC) appellent \u00e0 ne pas prescrire d&#39;azithromycine pour les patients COVID-19 trait\u00e9s \u00e0 domicile. Il n&#39;y a pas d&#39;efficacit\u00e9 prouv\u00e9e de l&#39;azithromycine pour COVID-19 (malgr\u00e9 les messages qui circulent \u00e0 ce sujet !) et il y a des risques impliqu\u00e9s.<\/strong><\/p>\n<ul>\n<li>Les donn\u00e9es sur l&#39;azithromycine chez les patients COVID-19 concernent une observation chez 6 patients qui ont re\u00e7u par hasard de l&#39;azithromycine dans une \u00e9tude sur l&#39;effet de l&#39;hydroxychloroquine&#x002C; trait\u00e9s en outre par azithromycine (voir \u00ab<a href='#Achtergrond'> Informations plus d\u00e9taill\u00e9es<\/a>\u00a0\u00bb).<\/li>\n<li>L&#39;effet dans l&#39;\u00e9tude concerne la n\u00e9gativation du test PCR et non la gu\u00e9rison des\u00a0patients.<\/li>\n<li>Il n&#39;y a pas de donn\u00e9es sur l&#39;administration d&#39;azithromycine seule.<\/li>\n<li>Cette petite \u00e9tude a \u00e9t\u00e9 men\u00e9e aupr\u00e8s de patients hospitalis\u00e9s gravement malades sous surveillance permanente.<\/li>\n<li>L&#39;azithromycine peut entra\u00eener un <a href='https:\/\/www.cbip.be\/fr\/chapters\/1?frag=9990169'>allongement de l&#39;intervalle QT<\/a> (avec risque de torsades de pointes). Cela vaut \u00e9galement pour la (hydroxy)chloroquine. Lorsque les deux m\u00e9dicaments sont associ\u00e9s et certainement lorsqu&#39;ils sont utilis\u00e9s dans des groupes \u00e0 risque (par exemple les personnes \u00e2g\u00e9es&#x002C; les patients atteints de cardiopathie)&#x002C; le risque augmente fortement.<\/li>\n<li>Le risque de r\u00e9sistance aux antibiotiques augmente.<\/li>\n<li>La disponibilit\u00e9 de l&#39;azithromycine est compromise pour les patients qui ont \u00e0 juste titre besoin d&#39;azithromycine.<br \/> Les risques sont donc plus \u00e9lev\u00e9s que les chances d&#39;am\u00e9lioration lorsque l&#39;azithromycine est utilis\u00e9e en ambulatoire chez les patients COVID-19.<\/li>\n<\/ul>\n<p>L&#39;Agence f\u00e9d\u00e9rale des m\u00e9dicaments et des produits de sant\u00e9 (AFMPS) a donc d\u00e9cid\u00e9 le 20 mars d&#39;imposer des quotas aux entreprises pour la livraison de sp\u00e9cialit\u00e9s \u00e0 base d&#39;azithromycine&#x002C; afin d&#39;en garantir la disponibilit\u00e9. En d\u00e9but de semaine&#x002C; l&#39;AFMPS a d\u00e9j\u00e0 d\u00e9cid\u00e9 de limiter la livraison d&#39;hydroxychloroquine et de chloroquine (<a href='https:\/\/www.cbip.be\/fr\/gows\/3306'>voir avis du 18 mars 2020<\/a>) ; le parac\u00e9tamol et certains antiviraux sont maintenant soumis \u00e0 des restrictions de d\u00e9livrance \/ livraison (voir aussi le site web de l&#39;AFMPS&#x002C; avis du <a href='https:\/\/www.afmps.be\/fr\/news\/coronavirus_lafmps_prend_des_mesures_pour_garantir_la_continuite_du_traitement_des_patients'>18 mars<\/a> et du <a href='https:\/\/www.afmps.be\/fr\/news\/coronavirus_ne_faites_pas_de_reserve_inutile_de_medicaments'>19 mars<\/a>).<br \/> \u00a0<\/p>\n<h3><a id='Achtergrond' name='Achtergrond'><\/a>Informations plus d\u00e9taill\u00e9es<\/h3>\n<p> La <a href='https:\/\/epidemio.wiv-isp.be\/ID\/Pages\/2019-nCoV_procedures.aspx'>proc\u00e9dure pour les <b>h\u00f4pitaux<\/b> et les <b>sp\u00e9cialistes \u201c<\/b>Traitement des patients hospitalis\u00e9s\u201d<\/a> (<b>version (anglaise) du <\/b><a href='https:\/\/epidemio.wiv-isp.be\/ID\/Documents\/Covid19\/COVID-19_InterimGuidelines_Treatment_ENG.pdf'><b>19\/03\/2020<\/b><\/a>)\u201d [Sciensano] mentionne : \u201c<i> Results of Gautret<\/i><span class='folia-referentie-note'>1&#39;<\/span>\u00a0<i>study have been just released and confirm that viral positivity in respiratory secretions (measured by PCR) is significantly decreased at day 6 in hydroxychloroquine-treated COVID-19 patients (n=26) versus those with supportive care (n=16 controls): 30% positivity versus 87.5%&#x002C; p<0.001). This observation strongly supports the current choice of hydroxychloroquine as first-line treatment; we suggest to keep the current recommended dosage (see Table)&#x002C; which is pharmacologically very close to that used in Gautret\u2019s study. <b>Of note&#x002C; in a small subgroup (n=6) of COVID patients incidentally treated with azithromycin for suspected bacterial superinfection&#x002C; a more pronounced viral suppression was observed&#x002C; but this observation is still too preliminary to recommend systematic administration of both drugs concomitantly&#x002C; taking into account some significant risks of interaction[15]<\/b>.<\/i>\u201d<br \/> \u00a0 <\/p>\n<h2>Sources sp\u00e9cifiques<\/h2>\n<p class='reference'><span class='folia-referentie-tekst'><span class='folia-referentie-nummer'>1<\/span> <\/span>Gautret P&#x002C; Lagier J&#x002C; Parola P&#x002C; Hoang V&#x002C; Meddeb L&#x002C; Mailhe M&#x002C; et al. Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial. International Journal of Antimicrobial Agents. In Press.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Les autorit\u00e9s sanitaires belges et les experts (dont BAPCOC) appellent  [&#8230;]<\/p>\n","protected":false},"author":9,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[12,61],"tags":[20213,20224],"class_list":["post-176475","post","type-post","status-publish","format-standard","hentry","category-actualites","category-2020-fr","tag-import_tags","tag-import_tags-nl"],"_links":{"self":[{"href":"https:\/\/h.cbip.be\/fr\/wp-json\/wp\/v2\/posts\/176475","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/h.cbip.be\/fr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/h.cbip.be\/fr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/h.cbip.be\/fr\/wp-json\/wp\/v2\/users\/9"}],"replies":[{"embeddable":true,"href":"https:\/\/h.cbip.be\/fr\/wp-json\/wp\/v2\/comments?post=176475"}],"version-history":[{"count":1,"href":"https:\/\/h.cbip.be\/fr\/wp-json\/wp\/v2\/posts\/176475\/revisions"}],"predecessor-version":[{"id":179054,"href":"https:\/\/h.cbip.be\/fr\/wp-json\/wp\/v2\/posts\/176475\/revisions\/179054"}],"wp:attachment":[{"href":"https:\/\/h.cbip.be\/fr\/wp-json\/wp\/v2\/media?parent=176475"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/h.cbip.be\/fr\/wp-json\/wp\/v2\/categories?post=176475"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/h.cbip.be\/fr\/wp-json\/wp\/v2\/tags?post=176475"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}