Treatment options used for management of COVID-19 in Pakistan: Timeline, reality, and challenges.

BACKGROUND Ever since the first reports of COVID-19 infections, the foremost requirement is to find a treatment regimen that not only fights the causative agent but also controls the associated complications of the infection. Due to time consuming process of drug discovery, doctors used readily available drugs and therapies for treatment of infections to minimize the death toll. OBJECTIVE To provide a snap-shot analysis of the major drugs used in a cohort of 1562 Pakistani patients during the May-July period when the first wave peaked in the country. METHODS A retrospective observational study providing an overview of major drugs used in a cohot of 1562 COVID-19 patients admitted to the four major tertiary-care hospitals in the Rawalpindi-Islamabad region of Pakistan during the peak of first wave in Country (May-July 2020). RESULTS Antibiotics were the most common choice out of all the therapies employed and were used as first line of treatment for COVID-19. Azithromycin was the most prescribed drug for the treatment. No trend was seen in choice of antibiotics monthly and it appeared like a random but favorite choice throughout these months. It was also noted that even antibiotics used for Multidrug resistant infections (MDR) were prescribed irrespective of the severity or progression of infections. Results of the analysis are aligned as it might lead to antibiotic resistance and complications in immunocompromised COVID-19 patients. A total of 1562 patients (68.1% males and 31.9% females) with a mean (SD) age of 47.35 (17.03) years were included in the study. The highest frequency of patient hospitalizations was in June (52.4%). CONCLUSIONS Guidelines for a targeted treatment regime is needed to control related complications and to limit the misuse of antibiotics in the management of Coronavirus. CLINICALTRIAL