When all the dust settles, we realize we've lost azithromycin, right?
Doctors from DC to Kampala give azithromycin for COVID even though it's a virus, even though <4% on hospital admit have a superinfection
It's not helping patients but makes providers feel good to do something

In case it needs to be said, azithro doesn't have superpowers. Added to standard treatment, it doesn't help https://www.thelancet.com/article/S0140-6736(20)31862-6/fulltext

Azithromycin, prescribed for every cold for the last couple of decades, was already faltering. It has already been removed from US IDSA/ATS first line treatment recs for community acquired pneumonia. Too much resistance https://thoracic.org/statements/resources/mtpi/idsaats-cap.pdf

Azithromycin resistance is not yet prevalent everywhere. Too expensive for many parts of the world it has been studied as a blanket means of reducing child mortality. Thing is, use it enough and you lose it. It can only last so long
https://www.nejm.org/doi/full/10.1056/nejmoa1715474 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6518950/

And we, the world, do need azithromycin. It's not just a drug to take or dispense when we feel like it. It's not just a med for those with penicillin allergies who don't really need an antibiotic. It has some important roles.

Notably, azithro is needed for Typhoid.

Typhoid kills about 200K a year and causes about 11-21 million cases. Those who die often have little voice in the world. They have poor sanitation and little access to running water. Hospitals and IV treatments can seem out of reach.

There is now XDR Typhoid.
There is a form of typhoid for which only one oral treatment remains - azithromycin, seen most notably in Pakistan.

We shouldn't waste the one oral treatment for a disease of the poorest people for no good reason.
https://wwwnc.cdc.gov/travel/notices/watch/xdr-typhoid-fever-pakistan