PUNE: At a time when all guidelines are advising cautious use of antivirals and antibacterials against Covid, experts, including those from the national task force, are becoming increasingly concerned about the heavy use of molnupiravir and azithromycin by doctors treating those with mild illness.
The experts said paracetamol and other supportive care are good enough to recover from mild disease.

Only those patients who are unvaccinated and with underlying conditions can be considered high-risk. These patients need to be monitored for progression towards severe symptoms and can be treated cautiously with the antiviral molnupiravir, the experts added.
“Molnupiravir is currently not recommended for mild illness due to modest benefit in an unvaccinated population. In the only molnupiravir study, a modest benefit was seen only among unvaccinated patients with obesity,” said Sanjay Pujari, a member of the national Covid task force.
“Similarly, antibacterials, including azithromycin, are also being unduly prescribed to mild Covid patients,” Pujari added.
Mumbai-based critical care expert Chandrashekhar T, director (critical care) at Fortis Hiranandani, said, “In many mild cases we know it’s pure viral. They can be treated symptomatically.”
He said, “Molnupiravir and Azithromycin have not been included in WHO guidelines and in the UK. Similarly, they have not been included in ICMR guidelines. Even our country’s task force has not listed molnupiravir and azithromycin for use. The Union health ministry has also raised the red flag as molnupiravir is not free from adverse effects. It’s also not indicated in pregnant women due to the chances of foetal defects.”
Molnupiravir is commercially available and can be bought with a doctor’s prescription.

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