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Revised guidelines for Covid-19 treatment in India: Ivermectin, Doxycycline removed

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  • All drugs, including zinc and multivitamin supplements, hydroxychloroquine dropped from Covid-19 treatment prescribed by health ministry; only the ones for fever and cold retained; HRCT only in cases of worsening symptoms

New Delhi: Most of the medicines that were being prescribed by doctors across the country for management of mild and asymptomatic cases of coronavirus infection have been dropped from the Covid-19 treatment prescribed by the Union Health Ministry of India. These include hydroxychloroquine, ivermectin, doxycycline, zinc, multivitamins, etc. Antipyretic (for fever) and anti-tussive (for cold) have been retained for such cases.

The revised comprehensive guidelines for management of Covid-19 patients, issued by the Directorate General of Health Services (DGHS) on May 27, come at a time when the number of new cases of Covid-19 is reducing daily. The ministry on Monday said that in the last 24 hours, the country reported 1.06 lakh new cases, the lowest single-day rise in two months.

Medical practitioners have also been discouraged from prescribing unnecessary tests like CT scan to the affected persons. HRCT is to be done only in case of worsening symptoms. Meanwhile, the emphasis on wearing mask properly, maintaining social distance at all times and washing hands regularly continues. Those with Covid-19 symptoms have been advised to seek treatment advice via teleconsultations, besides remaining hydrated and having a healthy balanced diet.

The guidelines state that for asymptomatic cases, there is no need for medication, except in cases where the patient has comorbidities. They can continue taking the prescribed medicines. For mild cases, the ministry has recommended self-monitoring for fever, breathlessness, oxygen saturation (SpO2), or worsening of symptoms. Antipyretic may be taken in case of fever, while anti-tussive may be taken for symptomatic relief. Inhalation of budesonide (given via metered-dose inhaler with space device) at a dose of 800 mcg twice a day for 5 days for a cough has been suggested.

‘No other Covid-19 specific medication is required. The patient may have to be investigated further if symptoms persist or deteriorate,’ the guideline said.

The six-minute walk test has been advised for self-monitoring. For this, the patient is asked to walk in the confines of his room for six minutes continuously while having the oximeter fitted to the finger. Any drop in saturation below 94% or an absolute drop of 3-5% or feeling unwell after the walk means the patient is positive for the walk test and may progress to become hypoxic. In such cases, early admission to hospital is recommended.

Patients and their families tend to get anxious because of the infection. To ease the situation, the ministry has advised them to remain connected and have positive conversations via regular and video calls.

Ivermectin, a much-debated drug, had been dropped off earlier. The WHO had noted that “the current evidence on the use of Ivermectin to treat COVID-19 patients is inconclusive”. Ivermectin, it said, was a broad spectrum anti-parasitic agent included in WHO essential medicines list for several parasitic diseases.

 

 

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