Off label, compassionate and irrational use of medicines in Covid-19 pandemic, health consequences and ethical issues
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Outros Autores: | |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Ciência & Saúde Coletiva (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1413-81232020000903413 |
Resumo: | Abstract When Covid-19 emerged in December last year, there was no vaccine nor was there specific effective treatment for this fast-spreading and life-threatening viral respiratory infection. Clinical trials were planned and are in progress to investigate whether drugs used for influenza, HIV and other viruses, and also anthelmintics (ivermectin, nitazoxanide, niclosamide), and antimalarials (chloroquine, hydroxychloroquine) showing antiviral activity in in vitro assays, are effective and safe for Covid-19. So far there is no convincing evidence that these antiviral and antiparasitic drugs are of any benefit for Covid-19. Notwithsanding the absence of evidence of clinical efficacy, these drugs are widely used outside of clinical trials (off label) for prophylaxis and treatment of this viral infection. The rationale behind the prescription of macrolide antibiotics (azithromycin) for Covid-19 is obscure as well. The widespread prescription and use of drugs of unproven efficacy and safety for Covid-19 is at odds with the rational use of medicines, a cornerstone principle of pharmacotherapy advanced by WHO in 1985. This irrational use of drugs is cause for concern because some of them are associated with serious heart disorders and deaths. |
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Off label, compassionate and irrational use of medicines in Covid-19 pandemic, health consequences and ethical issuesSARS-CoV-2Drug adverse eventsPharmacotherapyHydroxychloroquineAntibioticsAbstract When Covid-19 emerged in December last year, there was no vaccine nor was there specific effective treatment for this fast-spreading and life-threatening viral respiratory infection. Clinical trials were planned and are in progress to investigate whether drugs used for influenza, HIV and other viruses, and also anthelmintics (ivermectin, nitazoxanide, niclosamide), and antimalarials (chloroquine, hydroxychloroquine) showing antiviral activity in in vitro assays, are effective and safe for Covid-19. So far there is no convincing evidence that these antiviral and antiparasitic drugs are of any benefit for Covid-19. Notwithsanding the absence of evidence of clinical efficacy, these drugs are widely used outside of clinical trials (off label) for prophylaxis and treatment of this viral infection. The rationale behind the prescription of macrolide antibiotics (azithromycin) for Covid-19 is obscure as well. The widespread prescription and use of drugs of unproven efficacy and safety for Covid-19 is at odds with the rational use of medicines, a cornerstone principle of pharmacotherapy advanced by WHO in 1985. This irrational use of drugs is cause for concern because some of them are associated with serious heart disorders and deaths.ABRASCO - Associação Brasileira de Saúde Coletiva2020-09-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1413-81232020000903413Ciência & Saúde Coletiva v.25 n.9 2020reponame:Ciência & Saúde Coletiva (Online)instname:Associação Brasileira de Saúde Coletiva (ABRASCO)instacron:ABRASCO10.1590/1413-81232020259.16792020info:eu-repo/semantics/openAccessPaumgartten,Francisco José RomaOliveira,Ana Cecilia Amado Xavier deeng2020-08-25T00:00:00Zoai:scielo:S1413-81232020000903413Revistahttp://www.cienciaesaudecoletiva.com.brhttps://old.scielo.br/oai/scielo-oai.php||cienciasaudecoletiva@fiocruz.br1678-45611413-8123opendoar:2020-08-25T00:00Ciência & Saúde Coletiva (Online) - Associação Brasileira de Saúde Coletiva (ABRASCO)false |
dc.title.none.fl_str_mv |
Off label, compassionate and irrational use of medicines in Covid-19 pandemic, health consequences and ethical issues |
title |
Off label, compassionate and irrational use of medicines in Covid-19 pandemic, health consequences and ethical issues |
spellingShingle |
Off label, compassionate and irrational use of medicines in Covid-19 pandemic, health consequences and ethical issues Paumgartten,Francisco José Roma SARS-CoV-2 Drug adverse events Pharmacotherapy Hydroxychloroquine Antibiotics |
title_short |
Off label, compassionate and irrational use of medicines in Covid-19 pandemic, health consequences and ethical issues |
title_full |
Off label, compassionate and irrational use of medicines in Covid-19 pandemic, health consequences and ethical issues |
title_fullStr |
Off label, compassionate and irrational use of medicines in Covid-19 pandemic, health consequences and ethical issues |
title_full_unstemmed |
Off label, compassionate and irrational use of medicines in Covid-19 pandemic, health consequences and ethical issues |
title_sort |
Off label, compassionate and irrational use of medicines in Covid-19 pandemic, health consequences and ethical issues |
author |
Paumgartten,Francisco José Roma |
author_facet |
Paumgartten,Francisco José Roma Oliveira,Ana Cecilia Amado Xavier de |
author_role |
author |
author2 |
Oliveira,Ana Cecilia Amado Xavier de |
author2_role |
author |
dc.contributor.author.fl_str_mv |
Paumgartten,Francisco José Roma Oliveira,Ana Cecilia Amado Xavier de |
dc.subject.por.fl_str_mv |
SARS-CoV-2 Drug adverse events Pharmacotherapy Hydroxychloroquine Antibiotics |
topic |
SARS-CoV-2 Drug adverse events Pharmacotherapy Hydroxychloroquine Antibiotics |
description |
Abstract When Covid-19 emerged in December last year, there was no vaccine nor was there specific effective treatment for this fast-spreading and life-threatening viral respiratory infection. Clinical trials were planned and are in progress to investigate whether drugs used for influenza, HIV and other viruses, and also anthelmintics (ivermectin, nitazoxanide, niclosamide), and antimalarials (chloroquine, hydroxychloroquine) showing antiviral activity in in vitro assays, are effective and safe for Covid-19. So far there is no convincing evidence that these antiviral and antiparasitic drugs are of any benefit for Covid-19. Notwithsanding the absence of evidence of clinical efficacy, these drugs are widely used outside of clinical trials (off label) for prophylaxis and treatment of this viral infection. The rationale behind the prescription of macrolide antibiotics (azithromycin) for Covid-19 is obscure as well. The widespread prescription and use of drugs of unproven efficacy and safety for Covid-19 is at odds with the rational use of medicines, a cornerstone principle of pharmacotherapy advanced by WHO in 1985. This irrational use of drugs is cause for concern because some of them are associated with serious heart disorders and deaths. |
publishDate |
2020 |
dc.date.none.fl_str_mv |
2020-09-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1413-81232020000903413 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1413-81232020000903413 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/1413-81232020259.16792020 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
ABRASCO - Associação Brasileira de Saúde Coletiva |
publisher.none.fl_str_mv |
ABRASCO - Associação Brasileira de Saúde Coletiva |
dc.source.none.fl_str_mv |
Ciência & Saúde Coletiva v.25 n.9 2020 reponame:Ciência & Saúde Coletiva (Online) instname:Associação Brasileira de Saúde Coletiva (ABRASCO) instacron:ABRASCO |
instname_str |
Associação Brasileira de Saúde Coletiva (ABRASCO) |
instacron_str |
ABRASCO |
institution |
ABRASCO |
reponame_str |
Ciência & Saúde Coletiva (Online) |
collection |
Ciência & Saúde Coletiva (Online) |
repository.name.fl_str_mv |
Ciência & Saúde Coletiva (Online) - Associação Brasileira de Saúde Coletiva (ABRASCO) |
repository.mail.fl_str_mv |
||cienciasaudecoletiva@fiocruz.br |
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