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IDSA panel suggests five days of remdesivir for patients on supplemental oxygen

Among patients with Covid-19, the IDSA guideline panel recommends against hydroxychloroquine. Among hospitalised patients with Covid-19, the IDSA guideline panel recommends against hydroxychloroquine plus azithromycin.

Written by Anuradha Mascarenhas | Pune |
April 17, 2021 12:12:03 am
remdesivirAntiviral Remdesivir. (File Photo)

Covid-19 patients with supplemental oxygen who are not on mechanical ventilation can be treated with five days of remdesivir rather than 10 days of the injection, according to new recommendations from the Infectious Diseases Society of America Guidelines on the Treatment and Management of Patients with Covid-19, released on April 14.

In Covid patients admitted to the hospital without the need for supplemental oxygen and oxygen saturation greater than 94 per cent on room air, the IDSA panel suggests against the routine use of remdesivir. While many pharmacologic therapies are being used or considered for treatment, the IDSA identified the need to develop frequently updated evidence-based guidelines to support patients, clinicians and other health care professionals in their decisions about treatment and management of patients with Covid-19.

In a new paper on April 14, the IDSA has given recommendations related to the clinical practice guideline for the treatment and management of Covid-19. The recommendations in these guidelines are based on evidence from the best available clinical studies with patient-important endpoints, authors have said.

Among patients with Covid-19, the IDSA guideline panel recommends against hydroxychloroquine. Among hospitalised patients with Covid-19, the IDSA guideline panel recommends against hydroxychloroquine plus azithromycin. Among hospitalised patients with Covid-19, the IDSA guideline panel recommends against the use of the combination lopinavir/ritonavir. Among hospitalised critically ill patients with Covid-19, the IDSA guideline panel recommends dexamethasone rather than no dexamethasone.

The Maharashtra Covid-19 task force has also pointed out that most of the therapies are under emergency use authorisation and are experimental. “These are not magic bullets,” Dr Shashank Joshi, expert member of the State Covid-19 task force, told The Indian Express. He said that while remdesivir has a role in the first five days of the infection and improves clinical recovery and hospital stay by one to three days , it is not a life-saving drug.

As on Friday, there are 6,38,034 active Covid-19 cases in the state. Nearly one lakh cases are active with coronavirus infection in Pune district of which 53,157 are from PMC areas.

“Covid needs a stringent follow up for two weeks under supervised medical care and that is the key,” Joshi said. The task force chaired by Dr Sanjay Oak released a set of recommendations on April 7 for the management of Covid-19 patients. “In asymptomatic and mild cases, there may be a limited role for any drug but in moderate to severe cases, if saturation is dropping below 93 per cent and hospitalisation is needed, then core of therapy is oxygen, prone position, steroids and supportive care ,” Joshi said.

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