A 78-year-old resident of Salt Lake recently tested positive for Covid but had mild symptoms. Family members consulted a physician who prescribed an antibiotic, a combination of cefpodoxime and clavulanic acid that is mainly used to treat bacterial infections.
The doctor also prescribed vitamin and nutritional supplements.
“We consulted an infectious disease specialist attached to a private hospital, who told us to immediately stop the antibiotic and the supplements. My father had paracetamol for fever and used an inhaler. Now, he is doing well,” said his son.
Many physicians across Kolkata are still prescribing antibiotics, oral steroids and vitamin and nutritional supplements, though the Covid protocol issued by the health ministry and the state government have no mention about these drugs, said several doctors treating Covid patients in Kolkata.
During the current surge in Covid cases, most people who are testing positive are either asymptomatic or having mild symptoms, said health department officials.
On Monday, 1,915 new Covid cases were recorded across West Bengal. According to the health department, 23,576 Covid patients were in home isolation and only 633 in hospitals on Monday.
The revised Covid management protocol for those in home isolation, issued by the state health department, says:
- Supportive management
- Mask
- Hand hygiene
- Physical distancing
- Droplet precaution
- Paracetamol (for fever/ bodyache)
- Antihistamine (if needed)
- Laxative (if required)
- Inhalation of Budesonide 800mcg twice daily for five days if a distressing cough persists for more than five days.
The protocol also states: “Systemic steroids should NOT be used routinely in mild cases.”
“Despite clear guidelines, I am getting Covid patients who are advised antibiotics, particularly doxycycline and azithromycin, along with vitamins and nutritional supplements. Till the end of 2021, doxycycline was included in the protocol for treating Covid patients in home isolation. It was later withdrawn,” said Chandramouli Bhattacharya, infectious disease expert at Peerless Hospital.
“Doxycycline and azithromycin both possess immunomodulatory activity, which was thought to be effective in treating Covid. But later it was proven that these drugs have no role in Covid management,” said Bhattacharya.
“If the patient is young and healthy and has mild symptoms, I prescribe only paracetamol for fever. For patients who are elderly or have comorbidities, who have chances of developing severe disease, Budesonide 800mcg inhalation is prescribed,” he said.
Other doctors, too, said they were getting Covid patients who were unnecessarily on antibiotics.
“I am still getting Covid patients who have been prescribed antibiotics by physicians,” said Saurabh Maji, pulmonologist and critical care expert at the RN Tagore International Institute of Cardiac Sciences.
His advice for Covid patients: “Monitor oxygen saturation, drink plenty of fluids and take paracetamol for fever.”
Amitabha Saha, head of critical care at AMRI Mukundapur, said most patients in the current surge are having an upper respiratory tract infection. In the first two phases, the virus was damaging the lungs.
“We as physicians should restrain ourselves from prescribing antibiotics in such conditions. Steroids and antiviral drugs should be used only if the patient needs hospital admission for oxygen support and if there is no contraindication,” he said.
