Panel: Avoid remdesivir, use steroid only if O2 dips

Manav Mander

Tribune News Service

Ludhiana, August 14

Before the third wave hits the state, guidelines have been issued for handling of Covid-19 patients.

According to the latest clinical guidelines issued by the committee formed by the state government, unnecessary use of antimicrobials needs to be avoided, remdesivir injection has been discouraged and steroids will now be used only when oxygen saturation of the patient is less.

Dr Bishav Mohan, senior cardiologist at Hero DMC Heart Institute, who is also a member of Covid-19 task force formed by the government, said: “For patients requiring hospital management where a diagnosis of Covid is not established, and a differential diagnosis of community/hospital acquired pneumonia/or tropical fever is a possibility, after sending appropriate investigations, empiric antimicrobial(s) may be initiated with aim to de escalate as soon as correct diagnosis is established.”

Prescriptions to be reviewed every 48 hrs

High-dose steroids can cause diabetes and black fungus. So, these must be used only when saturation is less. Anti-fungal use should be limited and used for lab-proven infections only. All prescriptions must be reviewed every 48 hours. —Dr Bishav Mohan, Senior cardiologist

He said: “High dose steroids can cause diabetes and black fungus. So, these must be used only when saturation is less. Anti-fungal use should be limited and as far as possible for lab-proven infections only. All prescriptions must be reviewed within the next 48 hours.”

Remdesivir does not provide overall mortality benefit and may reduce time of clinical recovery. “Combined use of tocilizumab and baricitinib should be avoided as there is a potential for increased risk of infections,” Dr Mohan said.