Doctors flag unwarranted medication in COVID-19 fight

Drugs such as anti-bacterial azithromycin widely used

Azithromycin, an antibiotic drug to treat bacterial infections, is reportedly being widely used by people who have mild symptoms for COVID-19 in the ongoing third wave of the pandemic spurred by the Omicron variant of the virus. Doctors have flagged the use of such inappropriate medicines and unwanted hospitalisations, saying they are likely to result in more harm.

According to sources, there is a rise in the number of people using azithromycin following suggestions by local healthcare workers and Accredited Social Health Activists. Senior health professionals too are prescribing it to some patients. Health experts point out that it is not an over-the-counter-drug that can be freely used. It has not been included in the guidelines prepared by the World Health Organisation and the Union and State governments.

Meanwhile, the Campaign Against Pseudo Science Using Law and Ethics, a wing of the Kerala Sasthra Sahithya Parishad, has approached the State Drugs Controller, requesting imposition of curbs on the sale of the drug.

A group of doctors from across the country, in an open appeal to Health Ministers, the Indian Medical Association (IMA), and medical professionals, said that “unwarranted medications, tests, and hospitalisations that are inappropriate for the clinical management of COVID-19” were continuing.

They said a vast majority of infected persons, who were asymptomatic or with mild symptoms, would require little to no medication. They claimed that several COVID-19 kits and cocktails were part of the medical prescriptions they reviewed in recent weeks. The prescribing of vitamin combinations, azithromycin, doxycycline, hydroxychloroquine, favipiravir, and ivermectin was irrational, they said. “Such wanton use of drugs is not without harm as the Delta wave has shown. Outbreaks of opportunistic fungal infections like mucormycosis in India, and aspergillosis in Brazil were attributed to the widespread abuse of inappropriate medications,” they said. COVID-19 is a viral infection, that is not caused by a bacteria, seems to be the bottom line.

This group of doctors include Rajeev Jayadevan, who is part of the COVID task force of the IMA, and Cyriac Abby Philips of The Liver Institute, Rajagiri Hospital, Kochi.

A study titled ‘Bacterial co-infection and secondary infection in patients with COVID-19: a living rapid review and meta-analysis’ published by Bradley J. Langford and others had said that “bacterial co-infection is relatively infrequent in hospitalised patients with COVID-19. The majority of these patients may not require empirical antibacterial treatment.” The peer-reviewed study was published in Clinical Microbiology and Infection, a monthly publication of the European Society of Clinical Microbiology and Infectious Diseases.

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