ICMR Revises Covid Treatment Criteria and Addresses Co-Infection Issue

Amid rising cases of covid-19 in the country, The Indian Council of Medical Council (ICMR) has recently revised the clinical management guidelines for treating adult patients.

In the new treatment protocol, the apex medical research body warned about the irrational use of antibiotics and steroids while recommending considering the possibility of co-infection of covid with other endemic infections. The document said, "Systemic corticosteroids are not suggested in mild disease." It also wrote not to employ drugs such as Lopinavir-ritonavir, Hydroxychloroquine (HCQ), Ivermectin, convalescent plasma, neutralizing monoclonal antibody, Molnupiravir, Favipiravir, Azithromycin, and Doxycycline for treating the covid patients.

Many of these drugs, along with antibiotics and steroids, were frequently prescribed in India during the first wave of the pandemic. However, for this time, the government task force has suggested symptomatic treatment.

Mr. Rajesh Gokhale, secretary of the department of biotechnology, said." The present surge in the country is due to XBB.1.16 covid variant, which is milder, however more transmissible."

India is also witnessing an outbreak of H3N2 influenza, which has similar symptoms as covid, adding a greater risk of co-infection in communities.

Concerning the use of Dexamethasone, the expert panel, for the first time, has defined the appropriate usage and duration for patients in hospital settings. It said, "Dexamethasone 6 mg daily or equivalent dose of methylprednisolone (32 mg in 4 divided doses) for 5 to 10 days or until discharge, whichever is earlier." It also mentioned that there is no evidence of benefits in higher doses.

The panel also recommends that High-Resolution Computed Tomography (HRCT) chest be undertaken only in worsening cases and not mild ones. 

Raman Gangakhedkar, national co-chair and former Head of the epidemiology of ICMR, said, "Individuals should not self-medicate in covid and flu-like symptoms, rather should consult their physicians and obey covid appropriate behaviour."