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    Hydroxychloroquine/ chloroquine as a treatment choice or prophylaxis for Covid-19 at the primary care level in developing countries: A Primum non Nocere dilemma

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    Authors
    Medina MT
    Moncada, Salvador
    Affiliation
    Faculty of Medical Sciences, National Autonomous University of Honduras, WFN Regional Director for Latin America, Tegucigalpa, Honduras.
    Issue Date
    2020
    
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    Abstract
    The Food and Drug Administration (FDA) warned against the use of Hydroxychloroquine or chloroquine for Covid-19 outside of a hospital or a clinical trial setting due to the risk of QT interval prolongation, ventricular tachycardia and the increased risk of these complications when combined with some antibiotics such as azithromycin. Several studies have reported no benefit of Hydroxychloroquine or chloroquine, when used alone or with a macrolide in COVID-19 hospitalized patients. Despite these warnings, in several developing countries the official guidelines for treatment of Covid-19 patients at the primary care level recommend Hydroxychloroquine and azithromycin, among other treatments, as the first-choice for mild symptomatic Covid-19 patients, asymptomatic contacts or for prophylaxis. In our opinion there is a primum non nocere dilemma during this Covid-19 pandemic. In order to solve this bioethical problem, we strongly recommend that a randomized controlled trial in a primary care setting be carried out as a matter of urgency in these areas of the world. Keywords: Bioethics; Clinical trials; Developing countries; Hydroxychloroquine/ chloroquine; Primary care.
    Citation
    Medina MT, Moncada SS. Hydroxychloroquine/ chloroquine as a treatment choice or prophylaxis for Covid-19 at the primary care level in developing countries: A Primum non Nocere dilemma. J Neurol Sci. 2020;415:116972.
    Journal
    Journal of the Neurological Sciences
    URI
    http://hdl.handle.net/10541/623145
    DOI
    10.1016/j.jns.2020.116972
    PubMed ID
    32534369
    Additional Links
    https://dx.doi.org/10.1016/j.jns.2020.116972
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.jns.2020.116972
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