#WWYD: Insights From Doctors Across India Results from last week's poll
Five months ago, there were more than 100 distinct infectious diseases that might have explained that cough or fever. Right now, there seems to be only one disease: COVID-19. Has influenza disappeared from the planet? How about tuberculosis? Whooping cough? The common cold?
When somebody develops a cough and a fever, doctors ask themselves three questions:
1) What diseases can cause these signs and symptoms?
2) How common are the diseases themselves? and
3) How often will each disease produce cough and fever?
All that remains at this point is to make a mental list of these numbers and rank them.
In the midst of this, we took a poll to understand different opinions & perspectives of doctors on our platform. The situation provided was very common in doctor's everyday practice across India.
Q. "What would be your drug of choice for a patient having fever and cough for 2 days in this season, and why? (If RT-PCR result is awaited)"
Below are the results & we hope this discussion will provide everyone broader perspective on the subject.
• The patient can be given Symptomatic treatment such as antipyretic (Paracetamol) for fever and pain, antitussives for cough until RT-PCR results are out.
• Antibiotics should not be prescribed routinely unless there is clinical suspicion of a bacterial infection.
• Keeping the COVID-19 situation in mind, the patient to be advised for self-isolation alongside the ongoing treatment
• Avoid prescribing HCQ in patients with underlying cardiac disease
• Advice adequate nutrition and appropriate hydration
Here’s a snippet of their thoughts, in their own words…
"Both Azithtomycin and HCQ have QT prolongation as a CI and we don’t know if it’s viral. But if it’s a bacterial infection we can treat it with a suitable antibiotic lore doxycycline (wide spectrum AB)"
~ General Medicine (opted Doxycycline)
"Common causes of fever and cough in a tropical country includes viruses other than COVID and these are self limiting. So it will be a better option to provide symptomatic treatment pending RT-PCR report. Simultaneously advise for self isolation."
~ Internal Medicine (opted Symptomatic Management)
"Only favipiravir can show some promise in early stage of covid-19, but the treatment duration is long. We can initiate favipiravir early in high risk patients. However, we need more study with this drug. Also, Ivermectin combined with doxycycline or azithromycin is a good option for mild symptomatic patient without any risk factor."
~ Internal Medicine (opted Favipiravir)
Disclaimer: These insights shared by doctors are based on their personal experience and judgement. It does not constitute any medical advice.