Why carry out this study?

Published data are controversial on the efficacy of macrolides for COVID-19. This may be due to the varying time delay from infection onset until start of treatment

In the ACHIEVE study the clinical efficacy of clarithromycin was associated with the time delay since symptoms onset and with the mechanism of action

What was learned from the study?

Early clarithromycin treatment in patients with moderate COVID-19 is associated with most of clinical improvement

Treatment should start in the first 5 days from symptoms onset

The effect of clarithromycin is associated with increase of interferon-gamma production, decrease of interleukin-6 production and decrease of viral load