Off label, compassionate and irrational use of medicines in Covid-19 pandemic, health consequences and ethical issues

Detalhes bibliográficos
Autor(a) principal: Paumgartten,Francisco José Roma
Data de Publicação: 2020
Outros Autores: Oliveira,Ana Cecilia Amado Xavier de
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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spelling 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
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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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