The effect of antibiotics with potential antiviral and anti‐inflammatory properties are being investigated in clinical trials as treatment for COVID‐19.

We are certain that risk of death in hospitalised COVID‐19 patients is not reduced by treatment with azithromycin after 28 days.

Further, based on moderate‐certainty evidence, patients in the inpatient setting with moderate and severe disease probably do not benefit from azithromycin used as potential antiviral and anti‐inflammatory treatment for COVID‐19 regarding clinical worsening or improvement.

For the outpatient setting, there is currently low‐certainty evidence that azithromycin may have no beneficial effect for COVID‐19 individuals.

There is no evidence from RCTs available for other antibiotics as antiviral and anti‐inflammatory treatment of COVID‐19.

We included 11 studies with 11,281 participants with an average age of 54 years investigating antibiotics compared to placebo, standard of care alone or another antibiotic.

No study was found comparing antibiotics to an intervention with proven efficacy.

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