Hydroxychloroquine and Chloroquine Prescribing Patterns by Provider Specialty Following Initial Reports of Potential Benefit for COVID-19 Treatment — United States, January–June 2020

Bull-Otterson, Lara; Gray, Elizabeth B.; Budnitz, Daniel S.; Strosnider, Heather; Schieber, Lyna Z.; Courtney, Joseph G.; García, Macarena C.; Brooks, John T.; Kenzie, William R. Mac; Gundlapalli, Adi V.

doi:10.15585/mmwr.mm6935a4

Cited by 72 publications

(72 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As the evidence mounts on the lack of efficacy of hydroxychloroquine, chloroquine, and azithromycin for treatment of COVID-19, their initial use has now been halted in some settings (e.g. in the US [ Acosta et al, 2020 ; Bull-Otterson et al, 2020 ; Kadri et al, 2020 ]). However, misinformation ( Arshad et al, 2020 ), the lack of other treatment, combined with the severity of the illness, and a desire to try all avenues have led to several settings continuing to use these drugs.…”

Section: Covid-19 Impact On Amrmentioning

confidence: 99%

Antimicrobial resistance and COVID-19: Intersections and implications

Knight

Glover

McQuaid

et al. 2021

eLife

225

212

View full text Add to dashboard Cite

Before the coronavirus 2019 (COVID-19) pandemic began, antimicrobial resistance (AMR) was among the top priorities for global public health. Already a complex challenge, AMR now needs to be addressed in a changing healthcare landscape. Here, we analyse how changes due to COVID-19 in terms of antimicrobial usage, infection prevention, and health systems affect the emergence, transmission, and burden of AMR. Increased hand hygiene, decreased international travel, and decreased elective hospital procedures may reduce AMR pathogen selection and spread in the short term. However, the opposite effects may be seen if antibiotics are more widely used as standard healthcare pathways break down. Over 6 months into the COVID-19 pandemic, the dynamics of AMR remain uncertain. We call for the AMR community to keep a global perspective while designing finely tuned surveillance and research to continue to improve our preparedness and response to these intersecting public health challenges.

show abstract

Section: Covid-19 Impact On Amrmentioning

confidence: 99%

Antimicrobial resistance and COVID-19: Intersections and implications

Knight

Glover

McQuaid

et al. 2021

eLife

225

212

View full text Add to dashboard Cite

show abstract

“…In our opinion, no data justi ed their routine use and in March 2020 WHO stated: "Use of investigational anti-COVID-19 therapeutics should be done under ethically approved, randomized, controlled trials". [14] One may easily venture that unjusti ed recommendations presented in many of analyzed documents contributed to different clinical behavior, with frequent application of unproven therapies (example: hydroxychloroquine) [26][27][28][29] Of note most prestigious international panels including WHO and Surviving Sepsis Campaign were ready not to issue recommendation and instead urged rapid research. [13,14] strong.…”

Section: Discussionmentioning

confidence: 99%

Quality and Methodology of Clinical Practice Guidelines on Antiviral Pharmacotherapy for COVID-19 During the Early Phase of the Pandemic

Mejza

Leśniak

Jaeschke

2020

Preprint

View full text Add to dashboard Cite

BackgroundDespite availability of reliable guidelines development methods, the risk of producing less reliable documents may be higher when the guidelines are developed rapidly and high-quality evidence is lacking. The aim of this study was to assess the ways in which such documents, dealing with antiviral therapy, were developed in the early stages of COVID-19 pandemic and assess if recommendations were supported by evidence.MethodsWe performed the search for guidelines or similar documents, published before the results of any randomized controlled trials of COVID-19 treatment were available, that considered antiviral therapies and contained a recommendations for clinicians. The quality of the guidelines was assessed using the AGREE II-Global Rating Scale Instrument and series of dichotomous criteria based on the domain 3 of the AGREE II tool. We analyzed variables associated with the presence of recommendations, including strong ones, for antiviral therapy for SARS-CoV-2. Results The analysis included 40 publications, of which we classified 17 as clinical practice guidelines and 23 – as guidance or statements. The median of quality of documents assessed with the AGREE II-GRS tool (overall quality assessment on a scale ranging from 1-7) was 2.0 (IQR 1.5–2.5). Most documents did not fulfill the rigour of guideline development quality criteria. The AGREE II-GRS scores did not differ significantly across the type of the document, issuing institution and the mode of publication. Overall, 62.5% of documents provided recommendations for the use of antiviral medications despite apparent lack of sufficient evidence supporting such treatments. Documents that contained recommendations supporting antiviral drug use tended to be of lower quality than those without such recommendations. Of the included documents, 75% were not updated within the 2 months after the publication of the first randomized controlled trial on COVID-19 antiviral therapy. ConclusionsMost guidelines or guidance documents published during the early phase of the COVID-19 pandemic were of poor quality, contained recommendations for the use of antiviral therapy for SARS-CoV-2 infection despite only very low quality of evidence available, and were not updated on a regular basis. This information may be of value during this or future pandemics.

show abstract

“…However, as more clinical reports and studies were conducted, it became apparent that the drug commonly used to treat malaria was not effective in treating COVID-19. The FDA rescinded its recommendation and eventually EUA in April and June respectively, and the World Health Organization removed it from their coronavirus treatment trials (Bull-Otterson et al, 2020;Edwards, 2020;World Health Organization, 2020). We note that the initial effectiveness of HCQ against COVID-19 was unclear due to lack of evidence, but as more evidence showed that HCQ was in fact ineffective, this mirrors the change in factuality of HCQ as a treatment in the context of COVID-19 over time.…”

Section: Figure 2 Lockdown and Mask-related Tweets Within Primaries-mentioning

confidence: 99%

COVID-19 misinformation and the 2020 U.S. presidential election

et al. 2021

View full text Add to dashboard Cite

Voting is the defining act for a democracy. However, voting is only meaningful if public deliberation is grounded in veritable and equitable information. This essay investigates the politicization of public health practices during the Democratic primaries in the context of the 2020 U.S. presidential election, using a dataset of more than 67 million tweets. We find the public sphere on Twitter is politically heterogeneous and the majority—liberal and conservative alike—advocates for wearing masks and vote-by-mail. However, a small, but dense group of conservative users push anti-mask and voter fraud narratives.

show abstract

Hydroxychloroquine and Chloroquine Prescribing Patterns by Provider Specialty Following Initial Reports of Potential Benefit for COVID-19 Treatment — United States, January–June 2020

Abstract: safety-and-availability/fda-cautions-againstuse-hydroxychloroquine-or-chloroquine-covid-19-outside-hospital-setting-or. §

Cited by 72 publications

References 8 publications

Antimicrobial resistance and COVID-19: Intersections and implications

Antimicrobial resistance and COVID-19: Intersections and implications

Quality and Methodology of Clinical Practice Guidelines on Antiviral Pharmacotherapy for COVID-19 During the Early Phase of the Pandemic

COVID-19 misinformation and the 2020 U.S. presidential election

Contact Info

Product

Resources

About