Even before the US president tested positive for Covid-19, Dr. David Smith – an infectious disease consultant at the University of California, San Diego – said he was receiving daily calls from other doctors asking for advice on whether to prescribe the antiviral drug Paxlovid. for corona virus patients.
Smith said the calls are coming from “doctors who haven’t educate themselves on how to use the drug, and so are a little fickle about it.” “If I had a magic wand… one of the things I would like to do is make more people comfortable with the drug.”
The past month has seen increased scrutiny of Paxlovid’s potential benefits and drawbacks after Joe Biden and his chief medical advisor, Dr. Anthony FauciThey got the drug to treat their Covid-19 cases.
Infectious disease experts say the dearth of knowledge of the drug – some simply because it is new – and misconceptions about its usefulness have limited its ability to prevent patients from contracting the virus.
“I think unfortunately some clinicians have written off baxlovid as a poor option for patients who would benefit greatly from it based on a misperception that it is not working or not doing well,” Jennifer Nuzzo said. An epidemiologist and director of the Epidemiology Center at Brown University’s School of Public Health. “I’m just worried that we’re stealing people from an important tool.”
Baxlovid, which was developed by Pfizer and approved by the Food and Drug Administration late last year, is a combination of two antiviral drugs that “interfer with viral replication,” said William Schaffner, an infectious disease expert at Vanderbilt University School of Medicine.
This prevents the virus from causing more damage, Schaffner explained. The drug reduced the need for hospitalization for people with Covid-19 by 88% compared to patients who received a placebo during a clinical trial, According to the Food and Drug Administration.
Schaffner said Baxlovid is intended for patients at high risk of developing serious illness from the virus, such as older adults with underlying illnesses including diabetes and heart and lung disease, and people who are immunocompromised.
“Risk factors are very broad for eligibility for this drug: being heavy, being older,” Smith said. “Some comorbidities, such as high blood pressure and diabetes, put a person at greater risk, and thus qualify them for this drug.”
Despite its potential benefits, the drug has not been used enough and has been left on shelves to expire, according to government data And reports from doctors in the United States and in other places.
This is partly due to the limited time during which a drug can be beneficial, according to infectious disease experts.
For the drug to be effective, it must be taken within five days of the onset of symptoms. But people may not immediately test themselves when they have a sore throat or initially take a home test that provides a negative test result, before taking a second test a day later that shows they are positive, Andrew Pekos, a virologist at Johns Hopkins University, explained.
Many people don’t have a primary care doctor or an easy way to get to an urgent care center to get a prescription, Nozzo said.
“The clock starts ticking so much that you might miss the opportunity to start treatment,” Nozzo said.
To make it easier for patients to get the drug, the US Food and Drug Administration this month authorized pharmacists to prescribe the drug for Covid patients.
But another major concern among providers and patients is a potential rebound of Covid-19 symptoms after Paxlovid treatment. That’s what happened to Fauci, who has been the presidential top medical advisor throughout the pandemic. Tell news organizations His symptoms of reflux were worse than before the treatment but improved after a second course of baxlovid.
“The biggest question on people’s minds is whether they will experience a rebound with an infection,” Nozzo said. “The calculus is very clear for people who are at high risk of severe disease because that seems like a minor inconvenience compared to the possibility of going to the hospital. But for people who are not at high risk, I think there was a question as to whether they would really benefit from that. [Paxlovid]since we don’t know exactly how well they do in people who have been vaccinated and don’t have a high risk.”
Paxlovid, like other medicines, has possible side effects – patients have reported a metallic taste and diarrhea. Doctors should also consider its interaction with other medications.
“It’s not the easiest drug to prescribe,” Pecos said. “There are a lot of pre-existing cases where it can be difficult to prescribe baxlovid because it has some side effects.”
To help get the most out of this new tool, infectious disease experts have recommended that people immediately call their doctor if they contract Covid.
They also demanded more education for doctors. Smith recommended doctors review the National Institutes of Health Treatment Instructions Participation in continuing medical education forums about medication.
Another question on the public’s mind regarding Paxlovid is the potential effects it has on Biden’s health.
Smith said the Baxlovid study “actually reduced the risk of hospitalization and death significantly.” “So I think he’s in good hands with what’s going on and how it’s being treated, so I hope it’s just a bump in the road.”
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