May 20, 2022

ICMR Standards for Adverse Oral Antivirals, Antibiotics | India News

MUMBAI: Oral antivirals, antibiotics, monoclonal antibodies and vitamins have no place in India’s latest Covid management guidelines, which were published on the Union Health Ministry website on Monday.
The antiviral remdesivir, which is given by intravenous infusion, is recommended for moderately to severely ill patients on oxygen support. Off-label use of the rheumatoid arthritis drug tocilizumab continues for severe patients who do not improve on steroids. The guidelines come 10 days after ICMR chief Dr Balram Bhargav said a new oral antiviral, molnupiravir, had “safety concerns”.
Many doctors have a different opinion. “The general opinion of the medical community is that this omission is a mistake,” said infectious disease specialist Dr Om Shrivastava, a member of the Maharashtra task force.
The task force guidelines allow molnupiravir for patients over 50 with at least two comorbidities and continuous fever for at least three days. “Physicians should have the discretionary right to prescribe Molnupiravir because there is a subset of patients who benefit from it,” said infectious disease specialist Dr Anita Mathew.
ICMR guidelines state that patients with mild illness need symptomatic treatment for fever and pain and, if needed, a corticosteroid (budesonide) nasal spray. CT scans and expensive blood tests are only recommended for moderately and severely ill patients.
Last week, a group of 35 doctors wrote an open letter to Indian health authorities asking for updated guidelines that clearly state the government’s position on new antivirals and monoclonal antibodies so that “unnecessary drugs, tests and hospitalizations stop.
Dr Satchit Balsari of the Harvard School of Medicine and one of the signatories to the letter said: “It is reassuring to see that the new guidelines are evidence-based and avoid antibiotics. It is prudent, from a public health perspective, that other drugs that have marginal benefits and are not available to most people should also not be included. I hope the state agencies that have distributed drugs en masse will now abandon this practice.