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‘Living’ clinical guidelines update on antivirals


Anastasia Tsirtsakis


17/04/2020 4:39:29 PM

The National COVID-19 Clinical Evidence Taskforce has reviewed evidence on antivirals and other disease-modifying treatments.

Taking temperature
The guidelines launched with the aim of providing Australia’s healthcare professionals with a single source of evidence-based guidance.

Following considerable interest from clinicians on the frontline, the taskforce has reviewed evidence on the use of antivirals and other disease-modifying treatments for coronavirus patients, including:

  • antivirals – emdesevir, lopinavir and ritonavir
  • antimalarials – hydroxychloroquine and chloroquine
  • interleukin receptor agonists – tocilizumab and anakinra
  • corticosteroids
  • convalescent serum.
Despite further trials being identified, the taskforce said there is still insufficient evidence regarding benefits and harms to change its recommendation that these experimental treatments should only be administered in the context of clinical trials with appropriate ethical approval.
 
As part of its weekly update, the taskforce has issued more detailed guidance on the use of high-flow nasal oxygen therapy (HFNO) in different care settings, balancing benefits to patients and risks to healthcare workers.
 
New decision flowcharts have also been published for clinicians working in primary care – Assessment for suspected COVID-19 and Management of patients with suspected mild COVID-19.
 
The taskforce is currently reviewing evidence on:
 
  • steroid use in people with asthma and chronic obstructive pulmonary disease
  • continuous positive airway pressure
  • protocols for managing stroke and cardiac arrest.
Management of COVID-19 in special populations such as children, pregnant women and the immunosuppressed, as well as palliative care, have been identified as topics to be addressed by the taskforce imminently.
 
The ‘living’ clinical guidelines, Caring for people with COVID-19: Supporting Australia’s healthcare professionals with continually updated, evidence-based clinical guidelines, launched earlier this month with the aim of providing Australia’s healthcare professionals with a single source of guidance. They are updated weekly by a taskforce headed by Associate Professor Julian Elliott.
 
More than 170 clinical submissions have been made to date, with over 70 individual clinical and evidence experts contributing to review and answer them.
 
‘One of the real advantages of what we call a living evidence model is that it’s dynamic. So we do have the opportunity to respond to the key questions and concerns of clinicians,’ Associate Professor Elliott previously told newsGP.
 
‘We want to hear what their key clinical questions are, their concerns, fears, worries.’
 
The RACGP has more information on coronavirus available on its website.
 
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