New treatment guidelines drop ivermectin, zinc, vitamins, HCQ

Box

DGHS norms

No antibiotics for mild patients, no place for zinc, HCQ, vitamins, ivermectin

No steam inhalation (people doing this in excess)

Hydration, good diet, positive mindset, social connection stressed

Remdesivir, tocilizumab use only in severely ill cases

Blurb: DGHS norms at variance with ICMR advisory

Aditi Tandon

Tribune News Service

New Delhi, June 7

India on Monday issued a new clinical protocol for Covid treatment and dropped all commonly used treatments for mild patients of the infection, including antibiotics, hydroxychloroquine (HCQ), ivermectin and antiviral drug favipiravir.

WHO chief scientist Soumya Swaminathan today hailed the new evidence-based guidelines developed by the Director General of Health Services (DGHS) who said mildly ill Covid patients would be fine with just paracetamol, cough syrup and budesonide inhalation and need not be prescribed any antibiotics or major drugs at all.

This means the currently in use and much prescribed HCQ, favipiravir, ivermectin, azithromycin, doxycycline, zinc and vitamins are not required clinically and have no evidence of benefit.

The DGHS advice, however, is at variance with the ICMR advisory, which recommends both ivermectin and HCQ in mild cases. For asymptomatic patients, the new guidelines do not even recommend a blood test or any drugs and clarify “no investigation and no medications are needed at this stage”.

Mild patients would need investigation and paracetamol if symptoms of fever, cough, fatigue and other classical Covid signs persist or deteriorate.

The guidelines say no to Baba Ramdev’s Coronil and 2-DG drug for moderately ill patients and recommends monitoring of oxygen saturation, controlling comorbidities and giving steroids and anticoagulants as per medical advice.

The guidance lays down clear indications for the use of tocilizumab drug in severely ill patients and also tells doctors how and when to prescribe. It stresses the need to recruit a hospital infection committee to ensure prevention from fungal infections like mucormycosis and spells out a clear use and dosage of amphotericin B, which is in short supply currently.

The new advice says no to irrational and rampant use of chest CT scans and indicates when to use a chest X-ray. “Exercise extreme caution when ordering a chest CT scan. Patients must remain socially engaged and stay positive,” the guidance says, advising remdesivir in extreme cases and describing it as “an experimental drug with potential for harm”.