Thread by @mgtmccartney, GPs: reports that some are prescribing azithromycin and hydroxychloroquine to patients with [...]

GPs: reports that some are prescribing azithromycin and hydroxychloroquine to patients with suspected/confirmed #covid19 and who are being looked after at home.
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this should only be done in high quality, registered clinical trials with ethical oversight. thread:

we have had clear instructions not to prescribe these outwith trials. for good reason. here is gov advice
https://www.gov.uk/government/news/chloroquine-and-hydroxychloroquine-not-licensed-for-coronavirus-covid-19-treatment
here">https://www.gov.uk/governmen... is EMA advice https://www.ema.europa.eu/en/news/covid-19-chloroquine-hydroxychloroquine-only-be-used-clinical-trials-emergency-use-programmes">https://www.ema.europa.eu/en/news/c...

COVID-19: chloroquine and hydroxychloroquine only to be used in clinical trials or emergency use...

COVID-19: chloroquine and hydroxychloroquine only to be used in clinical trials or emergency use programmes

https://www.gov.uk/government/news/chloroquine-and-hydroxychloroquine-not-licensed-for-coronavirus-covid-19-treatment

here is the CEBM review
https://www.cebm.net/covid-19/chloroquine-and-hydroxychloroquine-current-evidence-for-their-effectiveness-in-treating-covid-19/
here">https://www.cebm.net/covid-19/... is NHSE advice
https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/gp-preparedness-update-letter-27-march-2020-.pdfharms">https://www.england.nhs.uk/coronavir...
here are concerns about supply chain to detriment ill people
https://www.theguardian.com/world/2020/mar/27/vital-drug-people-lupus-coronavirus-covid-19-link-hydroxychloroquine\">https://www.theguardian.com/world/202...

Vital drug for people with lupus running out after unproven Covid-19 link

Italy and France now prescribing hydroxychloroquine for coronavirus despite fact its effectiveness is unknown

https://www.cebm.net/covid-19/chloroquine-and-hydroxychloroquine-current-evidence-for-their-effectiveness-in-treating-covid-19/

yes we know that Donald Trump has a & #39;good feeling& #39; about HCQ, but he should have a better feeling about the importance of RCTs. why do we need fair tests of treatment?

we have had : cardiac drugs that were meant to stop heart attacks causing more deaths. drugs that were meant to help weight loss causing serious cardiac illness/death, it& #39;s a long list. read about it more here https://en.testingtreatments.org/book/2-hoped-for-effects-that-dont-materialize/">https://en.testingtreatments.org/book/2-ho...

2 - Hoped-for effects that don't materialize - EN Testing Treatments interactive

Neither theory nor expert opinion is a guide to the true effects of treatments. Often, hope can lead us to over-estimate their benefits.

https://en.testingtreatments.org/book/2-hoped-for-effects-that-dont-materialize/

in other words, we can *think* we are doing good things by doing *more* - it makes us look active, interested, keen to be ahead of the curve. sometimes this will be true. sometimes however it will very much *not* be true. we will have done harm.

there is a serious irony here. it& #39;s quite easy to off piste and start to do/prescribe all sorts of slightly mad things without anyone noticing for a while - you could do all sorts of harm without really needing much permission or oversight. this though

is ironic, because in practice it can be harder to acknowledge uncertainty and ask permission to deal with that (through setting up properly designed overseen quality trials) whereas if no such permission for trial and just do your mad things you do it until & #39;caught& #39;. anyway

doing off piste things means that some people will be unnecessarily harmed (except we wouldn& #39;t necessarily notice) (because they either are, or are not, getting the best available treatment). so this means that

the best thing to do is GET INVOLVED IN HIGH QUALITY CLINICAL TRIALS which are overseen, have checked evidence, have safety catches, either as doctor or patient. like here! https://www.nihr.ac.uk/covid-19/urgent-public-health-studies-covid-19.htm">https://www.nihr.ac.uk/covid-19/...

so: prescribing AZT/ HCQ outwith clinical trials: gonna no do that

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