Hydroxychloroquine/ chloroquine as a treatment choice or prophylaxis for Covid-19 at the primary care level in developing countries: A Primum non Nocere dilemma
AffiliationFaculty of Medical Sciences, National Autonomous University of Honduras, WFN Regional Director for Latin America, Tegucigalpa, Honduras.
MetadataShow full item record
AbstractThe 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.
CitationMedina 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.
JournalJournal of the Neurological Sciences
- Effect of Chloroquine, Hydroxychloroquine, and Azithromycin on the Corrected QT Interval in Patients With SARS-CoV-2 Infection.
- Authors: Saleh M, Gabriels J, Chang D, Soo Kim B, Mansoor A, Mahmood E, Makker P, Ismail H, Goldner B, Willner J, Beldner S, Mitra R, John R, Chinitz J, Skipitaris N, Mountantonakis S, Epstein LM
- Issue date: 2020 Jun
- [Hydroxychloroquine. Cardiology's viewpoint in times of coronavirus pandemic].
- Authors: Zaidel EJ, Wyss Quintana FS, Sosa Liprandi Á, Mendoza I, Márquez MF, Nuñez E, Barbosa M, Baranchuk A
- Issue date: 2020
- Proactive Prophylaxis With Azithromycin and HydroxyChloroquine in Hospitalised Patients With COVID-19 (ProPAC-COVID): A structured summary of a study protocol for a randomised controlled trial.
- Authors: Sivapalan P, Ulrik CS, Bojesen RD, Lapperre TS, Eklöf JV, Håkansson KEJ, Browatzki A, Tidemansen C, Wilcke JT, Janner J, Gottlieb V, Meteran H, Porsbjerg C, Madsen BL, Moberg M, Pedersen L, Benfield TL, Lundgren JD, Knop FK, Biering-Sørensen T, Ghanizada M, Sonne TP, Bødtger UCS, Jensen SG, Rasmussen DB, Brøndum E, Tupper OD, Sørensen SW, Alstrup G, Laursen CB, Møller UW, Sverrild A, Jensen JS
- Issue date: 2020 Jun 10
- Response to the editorial "COVID-19 in patients with cardiovascular diseases": Covid-19 treatment with hydroxychloroquine or chloroquine and azithromycin: A potential risk of Torsades de Pointes.
- Authors: Funck-Brentano C, Salem JE, Nguyen LS, Drici MD, Roden DM
- Issue date: 2020 May
- Efficacy of chloroquine and hydroxychloroquine in the treatment of COVID-19.
- Authors: Meo SA, Klonoff DC, Akram J
- Issue date: 2020 Apr