Doctors cautious over use of malaria drug as virus preventive-THE HINDU-25-03-2020

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File photo of Nivaquine, tablets containing chloroquine, a commonly used malaria drug that has shown signs of effectiveness against coronavirus.

Based on the recommendation of the Task Force for coronavirus disease , the Indian Council of Medical Research on Monday had approved the use of hydroxychloroquine as prophylaxis by healthcare workers taking care of COVID-19 cases and asymptomatic household contacts of confirmed cases. The clarification comes as none of the drug approving agencies across the world, including the FDA, has cleared the drug for prophylaxis or for treating COVID-19 patients.

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The available evidence of the efficacy of the drug is a small study by French researchers involving 26 COVID-19 patients. The study found “significant” reduction in viral load in over half the number of patients at end of six days of therapy. As the trial showed significant reduction, the results were published on March 17 in the International Journal of Antimicrobial Agents even before the 14-day follow-up was completed. The paper, which did not include the data of six patients, was published a day after it was submitted to the journal.

One of the authors is an Editor-in-Chief of the journal where the paper was published. During a White House press briefing a few days ago, asked if there was any evidence that the drug can be used as a prophylactic or as treatment for COVID-19 patients, Director of the U. Fauci’s clarification, two Nigerians are reported to have over-dosed on the drug after hearing President Donald Trump saying the drug could help treat people with COVID-19. There are ongoing trials. They must have waited for the results of the trials.

Even the trials are for treating COVID-19 patients and not for prophylaxis. The Atlanta-based Centres for Disease Control and Prevention says that based on “limited in-vitro and anecdotal data”, the drug has been recommended for treatment of COVID-19 patients in several countries. The drug is currently under investigation in clinical trials for pre-exposure or post-exposure prophylaxis and treatment. “There are no currently available data from randomised clinical trials to inform clinical guidance on the use, dosing, or duration of hydroxychloroquine for prophylaxis or treatment of SARS-CoV-2 infection,” CDC says.

As a prophylaxis, the drug may benefit healthcare workers who are taking care of COVID-19 patients. Anant Bhan, a researcher in global health and bioethics. “Using the drug as prophylaxis may give a false sense of security to healthcare workers and they may not use personal protective equipment or maintain hand hygiene.

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