National, Back Page

Experts warn against rampant use of dexamethasone

Published : 17 Jun 2020 09:57 PM | Updated : 06 Sep 2020 11:16 PM

People have been asked not to use dexamethasone for the treatment of Covid-19 patients without a doctor’s advice as this drug can turn out to be counterproductive if used indiscriminately.

 “We use steroid (dexamethasone and others) only when it’s indicated in serious patients needing oxygen,” Prof Dr Khan Abul Kalam Azad, a member of the national editorial board of the clinical management guideline committee, told Bangladesh Post.

 The comment came following reports that people in Bangladesh were stockpiling dexamethasone after an UK study found it useful in reducing Covid-19 death rate.

 But dexamethasone appears to help high-risk patients only and was not found to be effective in patients with milder symptoms.

 The World Health Organization (WHO) welcomed the initial results of the clinical trial that found for patients on ventilators, the treatment was shown to reduce mortality by about one third, and for patients requiring only oxygen, mortality was cut by about one fifth.

 Dr Azad, Professor of Medicine, said they were using steroids such as dexamethasone for the treatment of patients showing severe symptoms from the very beginning adding that it could be counterproductive to others.

 “We have to be careful while using it. We all must understand that steroid treatment is not for all. Only a specialist knows when to use it,” he said.

 He went on to say that routine use of steroids in Covid-19 patients can prolong their illness.

 Doctors are already dealing with a large number of cases of bacterial pneumonia in second and third weeks of coronavirus infections due to rampant use of steroids.

 In high-risk patients, dexamethasone appears to help stop some of the damage that can happen when the body's immune system goes into overdrive as it tries to fight off coronavirus. This over-reaction, a cytokine storm, can be deadly.

 “Only a specialist can judge this condition. We all have to keep in mind that its (steroid) use is meant for the high-risk cases. Doctors can prescribe this steroid for only the patients whose oxygen saturation level is falling with a probability of cytokine storm,” Dr Khan added.

 WHO said it was moving to update its guidelines on treating people stricken with Covid-19 after reflecting on the results of the clinical trial that showed this cheap, common steroid can help save “critically ill” patients.

 The drug has been available across the world since the 1960s to reduce inflammation in a range of other conditions, including arthritis, asthma and some skin conditions.