Most medical practitioners in the national capital are against random prescription of Tamiflu

Delhi rebels against Swine Flu diktats

Most medical practitioners in the national capital are against random prescription of Tamiflu

Apart from the war on the spread of Swine Flu a heated debate is on among those who are responsible to

control the influenza.

The guidelines were issued in the wake of the breakout of the Swine Flu epidemic across the country and as there was only one laboratory in Hyderabad to carry out the tests, the government had asked the medical practitioners not to wait for a diagnostic test before prescribing Tamiflu.

However, a lot of doctors in the national capital are not adhering to them as they apprehend that indiscriminate use of Tamiflu would create more problems than solving them.

"We have been asked to give Oseltamivir (Tamiflu) to patients with symptoms like high grade fever and severe soar throat, without conducting the test for H1N1," said a senior doctor at a government hospital, requesting anonymity.

He pointed out that a number of doctors are not following it, as indiscriminate use of Tamiflu will harm the patients.

"Unless we are sure that a patient is suffering from H1N1 how can we prescribe Tamiflu," said another doctor, refusing to be named.

"I only give Oseltamivir to a patient only when he/she tests positive for Swine Flu," said a doctor at a city government hospital where he attends to several flu patients every day.
Experts also pointed out that indiscriminate prescription of Tamiflu could actually bring more harm to
patients than curing them of influenza.

"The use of Oseltamivir has to be controlled and should not be given to everyone," said Dr S Chatterjee, senior consultant, internal medicine, Indraprastha Apollo Hospital.
"Without a diagnostic test to confirm the symptoms, Tamiflu cannot be given to anybody. Yes, if it is a matter of life and death the doctor should not wait for the reports," said Dr Vivek Nangia of Fortis Hospital, Vasant Kunj.

While the doctors in Delhi are not strictly adhering to the guidelines, in states like Goa, Gujarat and Rajasthan, Oseltamivir is being given to every patient with flu symptoms.
Dr C A Kante, officer in-charge at Maharashtra's swine flu control room, said all suspected patients with risk factors were given Tamiflu regardless of H1N1 test results.
"We are following the government guidelines," said Dr SJ Gandhi, Additional Director (Training & Epidemic), Directorate of Health Services, Rajasthan.

What the govt says?
"The test for Swine Flu costs around Rs 6000 to 7000, which is why we don't refer all patients for taking the test," said Dr Palliri Ravindran, director, emergency medical relief.
But, when asked about the consequences of not following the guidelines, he refused to comment.

Follow it up
Ministry of Family & Health Welfare issued guidelines for Pandemic Influenza A (H1N1) on October 5, 2009. In the guidelines, the government categorized the patients in three categories A, B and C.
Category A: Patients having mild fever plus cough/ sore throat with or without body ache, head ache, diarrhoea and vomiting to be monitored for 24 to 48 hours by the doctor.
Category B: Patients with high fever and severe sore throat may require home isolation and Oseltamivir (Tamiflu). But no tests fir H1N1 is required.
Category C: Patient having breathlessness, chest pain, drowsiness, and fall in blood pressure along with the symptoms of Category A and B should go for immediate testing, followed with hospitalization and treatment.

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