PUNE: Across cities, health experts now believe overprescription of drugs during Covid may have put scores at risk of serious ailments.

Last month, 35 eminent doctors from India and abroad wrote an open letter that said prescription of vitamins and medicines such as azithromycin, doxycycline, hydroxychloroquine, favipiravir and ivermectin was “irrational practice” and such a “wanton use of drugs” had led to the outbreak of mucormycosis during the second wave.

Doctors the news agency spoke to admitted that the early waves were marked by desperation, often prompting a trial-and-error approach.

“Do I believe we could’ve all used better guidelines? Yes,” said one doctor from Hyderabad, adding that the lack of a treatment protocol had led to confusion. “I know of cases in which patients’ kin demanded use of certain drugs. The doctors, who were groping in the dark themselves, had no choice but to relent,” the doctor said.

Treatment protocols have since improved. And many doctors said there are lessons to be learnt.

Rajesh Doshi, who specialises in treating senior patients, said, “Along with severity of symptoms, a patient’s tolerance also has to be considered while prescribing drugs. The same medication cannot be given to an 18, 25, 40 and 80 year-old patient, as they will tolerate it differently. The drug recently approved, molnupiravir, is to be prescribed with great caution, only to patients with severe symptoms.”

Sanjay Patil, chairperson of the IMA’s Hospital Board of India, Pune, said, “After two years, we are retrospectively realising that drugs such as azithromycin, doxycycline, hydroxychloroquine, favipiravir or steroids were not useful. After gathering data, we now have studies and guidelines from ICMR, the Covid task force and other government organisations that offer clear-cut directions to doctors treating Covid-19.”

Steroid overuse during the early waves had triggered a host of problems in Covid patients.

In August last year, doctors nationwide sounded the alarm after many recovered patients started turning up with bleeding piles, a fallout of combined and extensive use of blood thinner and steroids.

Doctors said that the Covid-19 pandemic has brought the problem of overprescription back under the spotlight. And a continuing concern is antibiotics.

Shuchin Bajaj, founder and director of Ujala Cygnus Group of Hospitals, said, “India has been unfortunate, in the sense that we have a lot of irrational practice particularly in regards to antibiotics, especially in the private practice domain. The most commonly overprescribed medicines are antibiotics. We have seen that anyone who comes to a clinic or a hospital is prescribed some sort of unnecessary antibiotics. I have seen even patients of heart attacks, admitted in hospitals, being prescribed third-generation cephalosporins, which is unfortunately a common practice in hospitals. We should follow evidence-based medicine and we need antibiotic stewardship at all hospitals and clinics with clear guidelines on usage.”