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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.
J Neurol Sci. 2020 08 15; 415:116972.JN

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.

Authors+Show Affiliations

Faculty of Medical Sciences, National Autonomous University of Honduras, WFN Regional Director for Latin America, Tegucigalpa, Honduras. Electronic address: marcotmedina@yahoo.com.Manchester Cancer Research Centre, The University of Manchester, Manchester, UK.

Pub Type(s)

Editorial
Comment

Language

eng

PubMed ID

32534369

Citation

Medina, Marco T., and Sir Salvador Moncada. "Hydroxychloroquine/ Chloroquine as a Treatment Choice or Prophylaxis for Covid-19 at the Primary Care Level in Developing Countries: a Primum Non Nocere Dilemma." Journal of the Neurological Sciences, vol. 415, 2020, p. 116972.
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.
Medina, M. T., & Moncada, S. S. (2020). Hydroxychloroquine/ chloroquine as a treatment choice or prophylaxis for Covid-19 at the primary care level in developing countries: A Primum non Nocere dilemma. Journal of the Neurological Sciences, 415, 116972. https://doi.org/10.1016/j.jns.2020.116972
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 08 15;415:116972. PubMed PMID: 32534369.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hydroxychloroquine/ chloroquine as a treatment choice or prophylaxis for Covid-19 at the primary care level in developing countries: A Primum non Nocere dilemma. AU - Medina,Marco T, AU - Moncada,Sir Salvador, Y1 - 2020/06/03/ PY - 2020/05/28/received PY - 2020/06/01/accepted PY - 2020/6/14/pubmed PY - 2020/7/16/medline PY - 2020/6/14/entrez KW - Bioethics KW - Clinical trials KW - Developing countries KW - Hydroxychloroquine/ chloroquine KW - Primary care SP - 116972 EP - 116972 JF - Journal of the neurological sciences JO - J Neurol Sci VL - 415 N2 - 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. SN - 1878-5883 UR - https://www.unboundmedicine.com/medline/citation/32534369/Hydroxychloroquine/_chloroquine_as_a_treatment_choice_or_prophylaxis_for_Covid_19_at_the_primary_care_level_in_developing_countries:_A_Primum_non_Nocere_dilemma_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-510X(20)30309-9 DB - PRIME DP - Unbound Medicine ER -