News

Covid-19: Govt suggests anti-malaria, anti-bacterial drug combo

Maitri Porecha New Delhi | Updated on April 02, 2020 Published on April 01, 2020

Revised guidelines say no specific antivirals have been proven to be effective

Antimalaria drug Hydroxychloroquine and antibacterial Azithromycin have been advised to be administered to confirmed patients of novel coronavirus in India by Ministry of Health and Family Welfare (MoHFW). The clinical guidelines were revised on March 31.

Uptil now MoHFW advisory said that only Hydroxylchoroquinine should be given as preventive treatment to healthcare workers and contacts of confirmed cases.

Also, anti-HIV drugs Lopinavir and Ritonavir were advised for patients with severe disease admitted in intensive care unit (ICU), which have now been removed.

In its expanded revised guidelines, the MoHFW states: “No specific antivirals have been proven to be effective as per currently available data. However, based on the available information (uncontrolled clinical trials), the following drugs may be considered as an off-label indication in patients with severe disease and requiring ICU management - Hydroxychloroquine 400 mg twice a day for one day, followed by 200 mg twice a day for 4 days, in combination with Azithromycin 500 mg once a day for 5 days.”

Study results

A French study published on March 20 in the New England Journal of Medicine treated 20 patients with this regimen and concluded that all six patients who were given the drug combination were 100 per cent virologically cured by end of sixth day. The study also said that of the other 14 patients who were only given the lone drug Hydroxychloroquine, only eight or 57.1 per cent were cured. This is the only limited evidence basis which India has revised its guidelines currently.

“Our preliminary results also suggest a synergistic effect of the combination of hydroxychloroquine and azithromycin. Azithromycin has been shown to be active in vitro against Zika and Ebola viruses and to prevent severe respiratory tract infections when administrated to patients suffering viral infection. This finding should be further explored to know whether a combination is more effective, especially in severe cases,” the NEJM study states.

Because the drug combo is feared to cause an erratic heart rate, the guidelines state that these drugs should be administered under close medical supervision, with monitoring for side effects including QTc interval, which is measurement of heart rate.

Children less than 12 years and pregnant or lactating women cannot be put on this regimen.

These guidelines are based on currently available information and would be reviewed from time to time as new evidence emerges,” MoHFW has stated.

On anti-HIV drugs Lopinavir and Ritonavir not being used in treatment anymore, Leena Menghaney from Doctors Without Borders said: “Data from clinical trials in China had suggested that anti-HIV drugs were in effective.” While initially two Italian patients from Jaipur were administered the anti-HIV drugs, one of them later died of heart attack. While globally doctors have said that Covid-19 leads to a weak heart, the MoHFW has maintained that the death was unrelated to the virus.

Published on April 01, 2020

A letter from the Editor


Dear Readers,

The coronavirus crisis has changed the world completely in the last few months. All of us have been locked into our homes, economic activity has come to a near standstill. Everyone has been impacted.

Including your favourite business and financial newspaper. Our printing and distribution chains have been severely disrupted across the country, leaving readers without access to newspapers. Newspaper delivery agents have also been unable to service their customers because of multiple restrictions.

In these difficult times, we, at BusinessLine have been working continuously every day so that you are informed about all the developments – whether on the pandemic, on policy responses, or the impact on the world of business and finance. Our team has been working round the clock to keep track of developments so that you – the reader – gets accurate information and actionable insights so that you can protect your jobs, businesses, finances and investments.

We are trying our best to ensure the newspaper reaches your hands every day. We have also ensured that even if your paper is not delivered, you can access BusinessLine in the e-paper format – just as it appears in print. Our website and apps too, are updated every minute, so that you can access the information you want anywhere, anytime.

But all this comes at a heavy cost. As you are aware, the lockdowns have wiped out almost all our entire revenue stream. Sustaining our quality journalism has become extremely challenging. That we have managed so far is thanks to your support. I thank all our subscribers – print and digital – for your support.

I appeal to all or readers to help us navigate these challenging times and help sustain one of the truly independent and credible voices in the world of Indian journalism. Doing so is easy. You can help us enormously simply by subscribing to our digital or e-paper editions. We offer several affordable subscription plans for our website, which includes Portfolio, our investment advisory section that offers rich investment advice from our highly qualified, in-house Research Bureau, the only such team in the Indian newspaper industry.

A little help from you can make a huge difference to the cause of quality journalism!

Support Quality Journalism
This article is closed for comments.
Please Email the Editor
You have read 1 out of 3 free articles for this week. For full access, please subscribe and get unlimited access to all sections.