Antibiotics should not be used unless there is clinical suspicion of bacterial infection: ICMR issues revised Covid-19 guidelines

The Indian Council of Medical Research (ICMR) has issued revised guidelines for Covid-19 in the wake of the surge of cases in the past week across the country.

“@ICMRDELHI COVID19 National Task Force, @aiims_newdelhi & Dte.GHS revised clinical guidance for management of adult #COVID19 patients. Guideline does not advice use of Lopinavir-ritonavir, HCQ, Ivermectin, Convalescent plasma, Molnupiravir, Favipiravir, Azithromycin, Doxycycline,” Dr Lokesh Sharma, Heath informatics researcher, ICMR tweeted.

“Antibiotics should not be used unless there is clinical suspicion of bacterial infection. The possibility of coinfection of COVID-19 with other endemic infections must be considered. Systemic corticosteroids are not indicated in mild disease,” revised guidelines said.

As per the revised Ccovid-19 guidelines, maintain “Physical distancing, indoor mask use, hand hygiene, Symptomatic management (hydration, anti-pyretics, antitussive) Monitor temperature and oxygen saturation (by applying a SpO probe to fingers) Stay in contact with treating physician.

“Seek immediate medical attention if difficulty breathing, High-grade fever/ severe cough, particularly if lasting for more than 5 days. A low threshold is to be kept for those with any of the high-risk features,” guidelines discussed and prepared in January said.

Additionally, in moderate or severe diseases at high risk of progression, the guidelines recommend, “Consider Remdesivir for up to 5 days (200 mg IV on day 1 followed by 100 mg IV OD for the next 4 days)”.

Union Health and Family Welfare Ministry on Thursday wrote to the State governments of Maharashtra, Gujarat, Telangana, Tamil Nadu, Kerala and Karnataka to follow a five-fold strategy of test, track, treat and vaccinations as these states witness a rise in Covid-19 cases.

India has observed a significant decline in the number of Covid-19 cases during the past few months. However, in the past few weeks a rise in cases has been noted specifically in certain parts of the country with a total of 2,082 cases reported in the week ending March 8, 2023, which rose to 3,264 cases in the week ending March 15, said the Union Home Ministry’s letter.

There are few States which are reporting a higher number of cases indicating the possible localized spread of infection and there is a need to follow a risk assessment-based approach to prevent and contain the infection, without losing the gains made so far in the fight against the pandemic, said the Union Health Ministry.

Gujarat has reported an increase in weekly cases from 105 in the week ending March 8, 2023, to 279 in the week ending March 15. Further, the State reported a positivity rate of 1.11 per cent in the week ending March 15 which is higher than India’s positivity rate of 0.61 per cent during the same period, the letter said.