{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T02:18:05Z","timestamp":1760235485931,"version":"build-2065373602"},"reference-count":49,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2021,8,25]],"date-time":"2021-08-25T00:00:00Z","timestamp":1629849600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>The aim of this study was to know the prevalence and severity of COVID-19 in patients treated with long-term macrolides and to describe the factors associated with worse outcomes. A cross-sectional study was conducted in Primary Care setting. Patients with macrolides dispensed continuously from 1 October 2019 to 31 March 2020, were considered. Main outcome: diagnosis of coronavirus disease-19 (COVID-19). Secondary outcomes: symptoms, severity, characteristics of patients, comorbidities, concomitant treatments. A total of 3057 patients met the inclusion criteria. Median age: 73 (64\u201381) years; 55% were men; 62% smokers\/ex-smokers; 56% obese\/overweight. Overall, 95% of patients had chronic respiratory diseases and four comorbidities as a median. Prevalence of COVID-19: 4.8%. This was in accordance with official data during the first wave of the pandemic. The most common symptoms were respiratory: shortness of breath, cough, and pneumonia. Additionally, 53% percent of patients had mild\/moderate symptoms, 28% required hospital admission, and 19% died with COVID-19. The percentage of patients hospitalized and deaths were 2.6 and 5.8 times higher, respectively, in the COVID-19 group (p &lt; 0.001). There was no evidence of a beneficial effect of long-term courses of macrolides in preventing SARS-CoV-2 infection or the progression to worse outcomes in old patients with underlying chronic respiratory diseases and a high burden of comorbidity.<\/jats:p>","DOI":"10.3390\/antibiotics10091039","type":"journal-article","created":{"date-parts":[[2021,8,26]],"date-time":"2021-08-26T00:19:26Z","timestamp":1629937166000},"page":"1039","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Sars-Cov-2 Infection in Patients on Long-Term Treatment with Macrolides in Spain: A National Cross-Sectional Study"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9603-2298","authenticated-orcid":false,"given":"Carmen Marina","family":"Meseguer Barros","sequence":"first","affiliation":[{"name":"Service of Pharmacy, Ouest Primary Health Care Area, Madrid Health Service, Madrid C\/Alonso Canonum 8, 28933 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8513-239X","authenticated-orcid":false,"given":"Natalia","family":"Alzueta Isturiz","sequence":"additional","affiliation":[{"name":"Unit of Drug Assessment, Advice and Research, Navarra Health Service, Pamplona, Plaza de la Paz s\/n, 31002 Pamplona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rita","family":"Sainz de Rozas Aparicio","sequence":"additional","affiliation":[{"name":"Service of Pharmacy, Cruces University Hospital, Osakidetza, Barakaldo, Vizcaya, Plaza Cruces s\/n, 48903 Barakaldo, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rafael Aguilella","family":"Vizca\u00edno","sequence":"additional","affiliation":[{"name":"Service of Pharmacy, North Primary Health Care Area, Madrid Health Service, Madrid C\/Alfonso Rodriguez Castelao 17, 28034 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"L\u00f3pez Esteban","sequence":"additional","affiliation":[{"name":"Service of Pharmacy, Center Primary Health Care Area, Madrid Health Service, Madrid C\/Alberto L\u00f3pez Palacios, 28021 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonia","family":"Anaya Ord\u00f3\u00f1ez","sequence":"additional","affiliation":[{"name":"Service of Pharmacy, Granada Metropolitano Primary Health Care Area, Andalusian Health Service, Complejo Administrativo Almanjayar C\/Joaquina Eguaras n\u00ba 2, Edificio 2 Planta 1, 18013 Granada, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Itxasne","family":"Lekue Alkorta","sequence":"additional","affiliation":[{"name":"Primary Care Pharmacy Service, Integrated Health Organization, Barakaldo-Sestao, Osakidetza, Avenida Antonio Miranda 5, 48902 Barakaldo, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salvadora","family":"Mart\u00edn Suances","sequence":"additional","affiliation":[{"name":"Service of Pharmacy, Granada Metropolitano Primary Health Care Area, Andalusian Health Service, Complejo Administrativo Almanjayar C\/Joaquina Eguaras n\u00ba 2, Edificio 2 Planta 1, 18013 Granada, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jorge Ignacio","family":"Jim\u00e9nez Arce","sequence":"additional","affiliation":[{"name":"Clinical Unit Primary Care Pharmacy Area VII Asturias, Principado de Asturias Health Service, Pza. Sindicatos Mineros num 3, 33600 Mieres, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maite","family":"Fern\u00e1ndez Vicente","sequence":"additional","affiliation":[{"name":"Service of Pharmacy, Burgos Primary Health Care, Castilla y Le\u00f3n Health, Burgos, Castilla y Le\u00f3n, C\/Calle Jos\u00e9 Mar\u00eda de la Puente, 09006 Burgos, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yolanda","family":"Borrego Izquierdo","sequence":"additional","affiliation":[{"name":"Cantabria Primary Care Management, Cantabrian Health Service, C\/Vargas n\u00ba 57 7 planta, 39010 Santander, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raquel","family":"Prieto S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Cantabria Primary Care Management, Cantabrian Health Service, C\/Vargas n\u00ba 57 7 planta, 39010 Santander, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia","family":"Casado Casuso","sequence":"additional","affiliation":[{"name":"Cantabria Primary Care Management, Cantabrian Health Service, C\/Vargas n\u00ba 57 7 planta, 39010 Santander, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2640-6872","authenticated-orcid":false,"given":"Rosa","family":"Madridejos","sequence":"additional","affiliation":[{"name":"Service of Pharmacy, Mutua Terrasa, Barcelona, CAP Sant Cugat, C\/de la Mina s\/n, 08173 Sant Cugat del Vall\u00e8s, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen Marquina","family":"Verde","sequence":"additional","affiliation":[{"name":"Service of Pharmacy, Burgos Primary Health Care, Castilla y Le\u00f3n Health, Burgos, Castilla y Le\u00f3n, C\/Calle Jos\u00e9 Mar\u00eda de la Puente, 09006 Burgos, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosa","family":"Tom\u00e1s Sanz","sequence":"additional","affiliation":[{"name":"Service of Pharmacy, Mutua Terrasa, Barcelona, CAP Sant Cugat, C\/de la Mina s\/n, 08173 Sant Cugat del Vall\u00e8s, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda","family":"Oro Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Primary Care Pharmacy and Residential Social Centers, Cantabrian Health Service, Santander, Cantabria, Av Herrera Oria s\/n, 39011 Santander, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Gallardo Borge","sequence":"additional","affiliation":[{"name":"Service of Pharmacy, Mutua Terrasa, Barcelona, CAP Sant Cugat, C\/de la Mina s\/n, 08173 Sant Cugat del Vall\u00e8s, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva","family":"L\u00e1zaro L\u00f3pez","sequence":"additional","affiliation":[{"name":"Clinical Unit Primary Care Pharmacy Area, Area VIII-Asturias, Principado de Asturias Health, Asturias, C\/Manuel Suarez s\/n, 33930 Langreo, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda Bel\u00e9n","family":"Pina Gadea","sequence":"additional","affiliation":[{"name":"Service of Primary Care Pharmacy, Zaragoza II Sector, Arag\u00f3n Health Service, Zaragoza, C\/Condes de Arag\u00f3n 30, 50009 Zaragoza, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mercedes","family":"Pereira P\u00eda","sequence":"additional","affiliation":[{"name":"San Roque Health Center, Lugo Health Area, Cervo Monforte, R\u00faa Pe\u00f1a Anda 1, 27002 Lugo, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda Victoria","family":"Maestre-S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Condado-Campi\u00f1a Health District, La Palma del Condado, C\/Ronda de los Legionarios 8, 21700 Huelva, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esther","family":"Ribes-Murillo","sequence":"additional","affiliation":[{"name":"Unit of Pharmacy, Lerida Primary Care Direction, Lerida Territorial Management, Catalan Institute of Health, Lerida, Catalu\u00f1a, Avenida de Blondel 23, 25002 Lleida, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Constanza","family":"G\u00f3mez de O\u00f1a","sequence":"additional","affiliation":[{"name":"Clinical Unit Primary Care Pharmacy Area V, Asturias, Principado de Asturias Health Service, Gij\u00f3n, Asturias C\/Severo Ochoa s\/n, 33208 Gij\u00f3n, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3803-5298","authenticated-orcid":false,"given":"\u00c1lvarez","family":"Mar\u00eda Jes\u00fas Lallana","sequence":"additional","affiliation":[{"name":"Service of Primary Care Pharmacy, Zaragoza II Sector, Arag\u00f3n Health Service, Zaragoza, C\/Condes de Arag\u00f3n 30, 50009 Zaragoza, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Concepci\u00f3n","family":"Celaya Lecea","sequence":"additional","affiliation":[{"name":"Pharmacy Sub-Directorate, Navarre Health Service, Pamplona, Plaza de la Paz s\/n, Planta 4, 31002 Pamplona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3617-3934","authenticated-orcid":false,"given":"Mar\u00eda Ana","family":"Prado Prieto","sequence":"additional","affiliation":[{"name":"Service of Pharmacy, Valladolid Primary Health Care, Castilla y Leon Health, Valladolid, Castilla y Le\u00f3n, Cardenal Torquemada n\u00ba 54, 47010 Valladolid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aranzazu","family":"Aranguez Ruiz","sequence":"additional","affiliation":[{"name":"M\u00e9rida Health Area Management, Merida Hospital, Badajoz, Extremadura, Av. Don Antonio Campos Hoyos 26, 06800 M\u00e9rida, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vicente","family":"Olmo Quintana","sequence":"additional","affiliation":[{"name":"Service of Pharmacy, Gran Canaria Health Area, Canary Islands Health Service, C\/Luis Doreste Silva 34-40, Canary Islands Health Service, 35004 Las Palmas de Gran Canaria, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noem\u00ed","family":"Vill\u00e9n Romero","sequence":"additional","affiliation":[{"name":"Primary Care Barcelona City, Catalan Institute of Health, Barcelona, C\/Manso 19, 1\u00aa Planta, 08015 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolina","family":"Pay\u00e1 Giner","sequence":"additional","affiliation":[{"name":"Health Management Area Campo de Gibraltar Pharmacy Unit, Pharmaceutical Primary Care, Carretera Getares, s\/n, 11207 Algeciras, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angeles","family":"Lloret Callejo","sequence":"additional","affiliation":[{"name":"Primary Care Management, Integrated Care Management Albacete-University Hospital Complex, Castilla-La Mancha Health Service, Albacete, Castilla La Mancha, C\/Hermanos Falc\u00f3 37, 02006 Albacete, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alvaro","family":"Fern\u00e1ndez Ferreiro","sequence":"additional","affiliation":[{"name":"Directorate of Health Care and Evaluation, Principado de Asturias Health Service, Oviedo, Asturias, Pza del Carbay\u00f3n 1, 33001 Oviedo, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6292-5207","authenticated-orcid":false,"given":"Blanca","family":"Basagoiti Carre\u00f1o","sequence":"additional","affiliation":[{"name":"Pharmacy Unit, Northwest Primary Health Care Area, Madrid Health Service, Madrid, Avda. De Espa\u00f1a 7, 28220 Majadahonda, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana Aurelia","family":"Iglesias Iglesias","sequence":"additional","affiliation":[{"name":"Pharmacy Service, Regional Hospital of Manacor, Balearic Islands Health Service, Inca, Balearic Islands, Carretera Manacor-Alcudia, s\/n, 07500 Manacor, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Mart\u00edn Alonso","sequence":"additional","affiliation":[{"name":"Pharmacy Unit, Northwest Primary Health Care Area, Madrid Health Service, Madrid, Avda. De Espa\u00f1a 7, 28220 Majadahonda, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"D\u00edez Alc\u00e1ntara","sequence":"additional","affiliation":[{"name":"Pharmacy Unit, Northwest Primary Health Care Area, Madrid Health Service, Madrid, Avda. De Espa\u00f1a 7, 28220 Majadahonda, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esther","family":"Marco Tej\u00f3n","sequence":"additional","affiliation":[{"name":"Cuenca Primary Care Management, Hospital Virgen de la Luz, Castilla La Mancha Health Service, C\/Hermandad de Donantes de Sangre 1, 16002 Cuenca, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"Lest\u00f3n V\u00e1zquez","sequence":"additional","affiliation":[{"name":"Primary Care Barcelona City, Catalan Institute of Health, Barcelona, C\/Manso 19, 1\u00aa Planta, 08015 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M\u00aa \u00c1ngeles","family":"Ariza Copado","sequence":"additional","affiliation":[{"name":"Pharmacy Unit, Management of Urgencies and Health Emergencies, Murcia, C\/Escultor Jos\u00e9 S\u00e1nchez Lozano N\u00ba 7, 2\u00aa planta, 30005 Murcia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"Aparicio Cueva","sequence":"additional","affiliation":[{"name":"Pharmaceutical Health Area, Health Department Alicante, Valencia C\/Pintor Baeza 12, (Edificio gris) 7\u00aa planta, 03010 Alicante, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bel\u00e9n","family":"Escudero Vilaplana","sequence":"additional","affiliation":[{"name":"Service of Pharmacy, Ouest Primary Health Care Area, Madrid Health Service, Madrid C\/Alonso Canonum 8, 28933 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marisa","family":"Nicieza","sequence":"additional","affiliation":[{"name":"Principado de Asturias Health Service Pharmacy Coordination, Central Services, Principado de Asturias Health Service, Asturias, Pza Carbay\u00f3n 1, 33001 Oviedo, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gracia","family":"Picazo Sanchiz","sequence":"additional","affiliation":[{"name":"Service of Pharmacy, Ouest Primary Health Care Area, Madrid Health Service, Madrid C\/Alonso Canonum 8, 28933 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Genma Mar\u00eda","family":"Silva Ri\u00e1digos","sequence":"additional","affiliation":[{"name":"Service of Pharmacy, Ouest Primary Health Care Area, Madrid Health Service, Madrid C\/Alonso Canonum 8, 28933 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luc\u00eda Jamart","family":"S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Service of Pharmacy, Ouest Primary Health Care Area, Madrid Health Service, Madrid C\/Alonso Canonum 8, 28933 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00c1ngel","family":"Garc\u00eda \u00c1lvarez","sequence":"additional","affiliation":[{"name":"Pharmacy Service, Tramuntana Sector, Inca Regional Hospital, Balearic Islands Health Service,  Balearic Islands, Carretera Vella de Llub\u00ed, s\/n, 07300 Inca, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Garc\u00eda Bonilla","sequence":"additional","affiliation":[{"name":"Pharmacy Unit, Jerez, Northwest Coast and Sierra de C\u00e1diz Primary Health Care Area, Jerez de la Frontera, C\u00e1diz, C\/Jos\u00e9 Luis Diez n\u00ba 14, 11402 Jerez de la Frontera, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rafael","family":"Herrero Delicado","sequence":"additional","affiliation":[{"name":"Pharmaceutical Management Service, General Directorate of Health Assistance, Murciano Health Service, Murcia Edificio Habitamia I C\/Central, 7-3\u00aa Planta, 30100 Espinardo, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Virginia","family":"Arroyo Pineda","sequence":"additional","affiliation":[{"name":"Talavera de la Reina Primary Care Management, Nuestra Se\u00f1ora del Prado Hospital, Castilla-La Mancha Health Service, Cuenca, Ctra. Madrid-Extremadura, Km 114, 45600 Toledo, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bel\u00e9n","family":"de la Hija","sequence":"additional","affiliation":[{"name":"Talavera de la Reina Primary Care Management, Nuestra Se\u00f1ora del Prado Hospital, Castilla-La Mancha Health Service, Cuenca, Ctra. Madrid-Extremadura, Km 114, 45600 Toledo, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amelia","family":"Troncoso Mari\u00f1o","sequence":"additional","affiliation":[{"name":"Primary Care Barcelona City, Catalan Institute of Health, Barcelona, C\/Manso 19, 1\u00aa Planta, 08015 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1375-7128","authenticated-orcid":false,"given":"Isabel","family":"Tofi\u00f1o Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Talavera de la Reina Primary Care Management, Nuestra Se\u00f1ora del Prado Hospital, Castilla-La Mancha Health Service, Cuenca, Ctra. Madrid-Extremadura, Km 114, 45600 Toledo, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M\u00f3nica Susana","family":"Mateu Garc\u00eda","sequence":"additional","affiliation":[{"name":"Pharmacy Service, Vinar\u00f3s Department of Health, Castell\u00f3n, Comunidad Valenciana, Av\/Gil de Atrocillo s\/n, 12500 Vinar\u00f2s, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pablo","family":"Garc\u00eda V\u00e1zquez","sequence":"additional","affiliation":[{"name":"Bierzo Health care Management, El Bierzo Hospital, Castilla y Le\u00f3n Health Service, C\/M\u00e9dicos sin Frontera, 7, 24404 Ponferrada, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joaqu\u00edn","family":"P\u00e9rez Mart\u00edn","sequence":"additional","affiliation":[{"name":"Faculty of Social Sciences, Area of Design, Gaming and Multimedia, Madrid, Calle Tajo s\/n, 28670 Villaviciosa de Od\u00f3n, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6261-6869","authenticated-orcid":false,"given":"Roc\u00edo","family":"Fern\u00e1ndez-Urrusuno","sequence":"additional","affiliation":[{"name":"Service of Pharmacy, Aljarafe-Sevilla Norte Primary Health Care Area, Avda de las Am\u00e9ricas s\/n, 41927 Mairena del Aljarafe, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,8,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1038\/s41586-020-2405-7","article-title":"Estimating the effects of non-pharmaceutical interventions on COVID-19 in Europe","volume":"584","author":"Flaxman","year":"2020","journal-title":"Nature"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Kim, M.S., An, M.H., Kim, W.J., and Hwang, T.-H. (2020). Comparative efficacy and safety of pharmacological interventions for the treatment of COVID-19: A systematic review and network meta-analysis. PLoS Med., 17.","DOI":"10.1371\/journal.pmed.1003501"},{"key":"ref_3","unstructured":"Recovery Collaborative Group (2021). Azithromycin in patients admitted to hospital with COVID-19 (RECOVERY): A randomised, controlled, open-label, platform trial. Lancet, 397, 605\u2013612."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1136\/thoraxjnl-2012-202698","article-title":"Azithromycin for prevention of exacerbations in severe asthma (AZISAST): A multicentrerandomised double-blind placebo-controlled trial","volume":"68","author":"Brusselle","year":"2013","journal-title":"Thorax"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1159\/000320320","article-title":"Immunomodulatory effects of macrolide antibiotics-part 2: Advantages and disadvantages of long-term, low-dose macrolide therapy","volume":"81","author":"Altenburg","year":"2011","journal-title":"Respiration"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1128\/CMR.00078-09","article-title":"Mechanisms of Action and Clinical Application of Macrolides as Immunomodulatory Medications","volume":"23","author":"Kanoh","year":"2010","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2767","DOI":"10.1093\/jac\/dkw222","article-title":"Identification of novel macrolides with antibacterial, anti-inflammatory and type I and III IFN-augmenting activity in airway epithelium","volume":"71","author":"Porter","year":"2016","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1016\/j.coph.2008.01.010","article-title":"Macrolides as immunomodulatory medications for the therapy of chronic lung diseases","volume":"8","author":"Rubin","year":"2008","journal-title":"Curr. Opin. Pharmacol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1007\/s00228-011-1161-x","article-title":"Macrolides: From in vitro anti-inflammatory and immunomodulatory properties to clinical practice in respiratory diseases","volume":"68","author":"Zarogoulidis","year":"2011","journal-title":"Eur. J. Clin. Pharmacol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1016\/S0140-6736(17)31281-3","article-title":"Effect of azithromycin on asthma exacerbations and quality of life in adults with per-sistent uncontrolled asthma (AMAZES): A randomised, double-blind, placebo-controlled trial","volume":"390","author":"Gibson","year":"2017","journal-title":"Lancet"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1901381","DOI":"10.1183\/13993003.01381-2019","article-title":"Does maintenance azithromycin reduce asthma exacerbations? An individual participant data meta-analysis","volume":"54","author":"Hiles","year":"2019","journal-title":"Eur. Respir. J."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1016\/S2213-2600(14)70107-9","article-title":"The role of macrolides in asthma: Current evidence and future directions","volume":"2","author":"Wong","year":"2014","journal-title":"Lancet Respir. Med."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Herath, S.C., Normansell, R., Maisey, S., and Poole, P. (2018). Prophylactic antibiotic therapy for chronic obstructive pulmonary disease (COPD). Cochrane Database Syst. Rev.","DOI":"10.1002\/14651858.CD009764.pub3"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1016\/S2213-2600(14)70019-0","article-title":"Azithromycin maintenance treatment in patients with frequent exacerbations of chronic obstructive pulmonary disease (COLUMBUS): A randomised, double-blind, placebo-controlled trial","volume":"2","author":"Uzun","year":"2014","journal-title":"Lancet Respir. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1016\/S0140-6736(12)60953-2","article-title":"Azithromycin for prevention of exacerbations in non-cystic fibrosis bronchiectasias (EMBRACE): A randomised, double-blind, placebo-controlled trial","volume":"380","author":"Wong","year":"2012","journal-title":"Lancet"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1251","DOI":"10.1001\/jama.2013.1937","article-title":"Effect of azithromycin maintenance treatment on infectious exacerbations among patients with non-cystic fibrosis bronchiectasis: The BAT randomized controlled trial","volume":"209","author":"Altenburg","year":"2013","journal-title":"JAMA"},{"key":"ref_17","first-page":"CD002203","article-title":"Macrolide antibiotics for cystic fibrosis","volume":"11","author":"Southern","year":"2012","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/j.pharmthera.2014.03.003","article-title":"Azithromycin: Mechanisms of action an their relevance for clinical applications","volume":"143","author":"Parnham","year":"2014","journal-title":"Pharmacol. Ther."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"105949","DOI":"10.1016\/j.ijantimicag.2020.105949","article-title":"Hydroxychloroquine and azithromycin as a treatment of COVID-19: Results of an open-label non-randomized clinical trial","volume":"56","author":"Gautret","year":"2020","journal-title":"Int. J. Antimicrob. Agents"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2493","DOI":"10.1001\/jama.2020.8630","article-title":"Association of Treatment With Hydroxychloroquine or Azithromycin With In-Hospital Mortality in Patients With COVID-19 in New York State","volume":"323","author":"Rosenberg","year":"2020","journal-title":"JAMA"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2041","DOI":"10.1056\/NEJMoa2019014","article-title":"Hydroxychloroquine with or without Azithromycin in Mild-to-Moderate Covid-19","volume":"383","author":"Cavalcanti","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1016\/S0140-6736(20)31862-6","article-title":"Azithromycin in addition to standard of care versus standard of care alone in the treatment of patients admitted to the hospital with severe COVID-19 in Brazil (COALITION II): A randomised clinical trial","volume":"396","author":"Furtado","year":"2020","journal-title":"Lancet"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"PRINCIPLE Trial Collaborative Group (2021). Azithromycin for community treatment of suspected COVID-19 in people at increased risk of an adverse clinical course in the UK (PRINCIPLE): A randomised, controlled, open-label, adaptative platform trial. Lancet, 397, 1063\u20131074.","DOI":"10.1016\/S0140-6736(21)00461-X"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1186\/s13063-020-04593-8","article-title":"A randomised clinical trial of azithromycin versus standard care in ambulatory COVID-19\u2014The ATOMIC2 trial","volume":"21","author":"Hinks","year":"2020","journal-title":"Trials"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e00692","DOI":"10.1002\/prp2.692","article-title":"Patients receiving a high burden of antibiotics in the community in Spain: A cross-sectional study","volume":"9","author":"Izquierdo","year":"2021","journal-title":"Pharm. Res. Perspect."},{"key":"ref_26","unstructured":"Ministerio de Sanidad (2021, June 04). Consejo Interterritorial del Sistema Nacional de Salud e Instituto de Salud Carlos III. Estudionacional de Seroepidemiolog\u00edade la Infecci\u00f3npor SARS-CoV-2 enEspa\u00f1a (ENE-COVID19). (In Spanish)."},{"key":"ref_27","unstructured":"Equipo COVID-19 (2020, May 30). RENAVE. Informe n\u00ba 33. An\u00e1lisis de Loscasos de COVID-19 Notificados a la RENAVE Hasta el 10 de Mayo enEspa\u00f1a a 29 de mayo de 2020. (In Spanish)."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Working Group for the Surveillance and Control of COVID-19 in Spain (2021, May 30). The First Wave of the COVID-19 Pandemic in Spain: Characterisation of Cases and Risk Factors for Severe Outcomes, as at 27 April 2020. Available online: https:\/\/www.eurosurveillance.org\/content\/ecdc2020;25:2001431.","DOI":"10.2807\/1560-7917.ES.2020.25.50.2001431"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1818","DOI":"10.1093\/jac\/dkx048","article-title":"Antibiotic prescribing frequency amongst patients in primary care: A cohort study using electronic health records","volume":"72","author":"Shallcross","year":"2017","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1054","DOI":"10.1016\/S0140-6736(20)30566-3","article-title":"Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: A retrospective cohort study","volume":"395","author":"Zhou","year":"2020","journal-title":"Lancet"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e25452","DOI":"10.2196\/25452","article-title":"Clinical Characterization of Patients With COVID-19 in Primary Care in Catalonia: Retrospective Observational Study","volume":"7","author":"Mayer","year":"2021","journal-title":"JMIR Public Health Surveill."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1159\/000510953","article-title":"Does Asthma Increase the Mortality of Patients with COVID-19?: A Systematic Review and Meta-Analysis","volume":"182","author":"Wang","year":"2020","journal-title":"Int. Arch. Allergy Immunol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1080\/08959420.2020.1764310","article-title":"Who are the Most At-Risk Older Adults in the COVID-19 Era? It\u2019s Not Just Those in Nursing Homes","volume":"32","author":"Cohen","year":"2020","journal-title":"J. Aging Soc. Policy"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"108509","DOI":"10.1016\/j.clim.2020.108509","article-title":"Early predictors of clinical outcomes of COVID-19 outbreak in Milan, Italy","volume":"217","author":"Ciceri","year":"2020","journal-title":"Clin. Immunol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1136\/gutjnl-2020-322248","article-title":"Severe clinical outcomes of COVID-19 associated with proton pump inhibitors: A nation-wide cohort study with propensity score matching","volume":"70","author":"Lee","year":"2021","journal-title":"Gut"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Hansen, E.S.H., Moeller, A.L., Backer, V., Andersen, M.P., Kober, L., Kragholm, K., and Torp-Pedersen, C. (2020). Severe outcomes of COVID-19 among patients with COPD and asthma. ERJ Open Res., 7.","DOI":"10.1183\/23120541.00594-2020"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1038\/s41586-020-2521-4","article-title":"Factors associated with COVID-19-related death using OpenSAFELY","volume":"584","author":"Williamson","year":"2020","journal-title":"Nature"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1468","DOI":"10.1093\/ije\/dyaa140","article-title":"Characteristics and predictors of hospitalisation and death in the first 11,122 cases with positive RT-PCR test for SARS-CoV-2 in Denmark: A nationwide cohort","volume":"49","author":"Reilev","year":"2020","journal-title":"Int. J. Epidemiol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1622","DOI":"10.1016\/j.cmi.2020.07.016","article-title":"Bacterial co-infection and secondary infection in patients with COVID-19: A living rapid review and meta-analysis","volume":"26","author":"Langford","year":"2020","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.cmi.2020.09.041","article-title":"Recommendations for antibacterial therapy in adults with COVID-19\u2014An evidence based guideline","volume":"27","author":"Sieswerda","year":"2020","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1001\/jama.2021.11517","article-title":"Effect of Oral Azithromycin vs. Placebo on COVID-19 Symptoms in Outpatients With SARS-CoV-2 Infection: A Randomized Clinical Trial","volume":"326","author":"Oldenburg","year":"2021","journal-title":"JAMA"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"RECOVERY Collaborative Group (2020). Effect of Hydroxychloroquine in Hospitalized Patients with Covid-19. N. Engl. J. Med., 383, 2030\u20132040.","DOI":"10.1056\/NEJMoa2022926"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"m1985","DOI":"10.1136\/bmj.m1985","article-title":"Features of 20 133 UK patients in hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: Prospective observational cohort study","volume":"369","author":"Docherty","year":"2020","journal-title":"BMJ"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1011","DOI":"10.1007\/s00228-014-1704-z","article-title":"Improving the appropriateness of antimicrobial use in pri-mary care after the implementation of a local antimicrobial guide in both levels of care","volume":"70","author":"Urrusuno","year":"2014","journal-title":"Eur. J. Clin. Pharmacol."},{"key":"ref_45","unstructured":"WHO Collaborating Centre for Drug Statistics Methodology (2021, January 05). ATC\/DDD Index 2010. Available online: http:\/\/www.whocc.no\/atc_ddd_index."},{"key":"ref_46","unstructured":"(2021, January 04). Instituto Nacional de Estad\u00edstica. Available online: https:\/\/www.ine.es."},{"key":"ref_47","unstructured":"(2021, June 04). Estrategia de Diagn\u00f3stico, Vigilancia y Control en la Fase de Transici\u00f3n de la Pandemia COVID-19. Indicadores de Seguimiento. Updated 12 May 2020. (In Spanish)."},{"key":"ref_48","unstructured":"Ministerio de Sanidad (2021, June 04). Enfermedadpor Coronavirus, COVID-19. Updated 17 April 2020. (In Spanish)."},{"key":"ref_49","unstructured":"Laporte, J.R., and Healey, D. (2021, June 04). Enmedio de la Pandemiapor SARS-CoV-2, Esnecesariaprudencia con f\u00e1Rmacos de Consume Frecuente que Incrementan el Riesgo de Neumon\u00eda. Direcci\u00f3n General de Productos Sanitarios. Inf Farmacoterde la ComunitatValencian. (In Spanish)."}],"container-title":["Antibiotics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-6382\/10\/9\/1039\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:52:00Z","timestamp":1760165520000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-6382\/10\/9\/1039"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,25]]},"references-count":49,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2021,9]]}},"alternative-id":["antibiotics10091039"],"URL":"https:\/\/doi.org\/10.3390\/antibiotics10091039","relation":{},"ISSN":["2079-6382"],"issn-type":[{"type":"electronic","value":"2079-6382"}],"subject":[],"published":{"date-parts":[[2021,8,25]]}}}