BENGALURU: A recent meta analysis published in Clinical Microbiology and Infection journal stated that Hydroxychloroquine (HCQ) alone was not associated with reduced mortality in hospitalised patients, but a combination of Hydroxychloroquine and Azithromycin significantly increased mortality.
Doctors, too, are moving away from the drugs. Instead of HCQ and Azithromycin, they are using Doxycycline, Ivermectin, Ecosprin, Ceftriaxone, Bronchodialator and N-Acetyl Cysteine.
Dr Bindumathi PL, senior consultant, Internal Medicine, Aster CMI Hospital, said, “We are not using HCQ or Azithromycin, or a combination of the two, owing to cardiac side-effects such as prolonged QT interval in the heart. We are using Doxycycline which acts as an immune system modulator, has anti-inflammatory and anti-viral properties, and responds to the cytokine storm. Ecosprin, a prophylactic which prevents complications like thrombosis, is also used.”
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In addition, she uses Ceftriaxone to prevent other infections, Bronchodialator which lets oxygen enter the lungs, N-Acetyl Cysteine which acts as an antioxidant, and steroids. Dr C Nagaraj, director of RGICD, said, “HCQ is resulting in many adverse effects like cardiac attacks, especially on people with comorbidities. Hence, we have moved to Doxycycline and Ivermectin which are proving to be more effective.” However, quoting studies that show that low doses of HCQ keeps the severity of the virus low in patients, a section of the medical community uses it with Azithromycin.
Vouching for it, Dr Satyanarayana Mysore, HOD, Pulmonology Respiratory and Sleep Medicine, Lung Transplant Physician at Manipal Hospitals, said HCQ prevents viral multiplication but doesn’t have an effect when the patient is in the last stages, where there is hyper inflammation. “We have used a combination of HCQ and Azithromycin and it has not had any adverse effects except for gastritis,” he said. However, these patients do not have pre-existing conditions, are younger and do not have prolonged QT intervals.