Drug management of adult hospital in-patients with COVID-19 infection following LFT / PCR positive (Guidelines)

Warning
  • All NHS Highland
  • Secondary Care only
  • Adults only

Patients who are on oxygen: New O2 or ↑O2 need secondary to COVID infection

  1. Start dexamethasone as per TAM
  2. Assess suitability for tocilizumab as per TAM
  3. If unsuitable for tocilizumab, consider baricitinib as per TAM

If severe pneumonitis with poor response to therapy, discuss with Infectious Diseases or Microbiology.

Is the patient on the Highest Risk List?

YES NO
Consider remdesivir. NB benefit may be greatest during early phase of infection. See: remdesivir SPC Antivirals are not recommended in this group. 

Patients who are NOT on oxygen.

If severe pneumonitis with poor response to therapy, discuss with Infectious Diseases or Microbiology.

Is the patient on the Highest Risk List?

YES NO
  1. Nirmatrelvir / ritonavir (Paxlovid). See: Paxlovid SPC
  2. Consider remdesivir, if Paxlovid unsuitable. See: remdesivir SPC
  3. (Only within 5 days of symptom onset). Consider molnupiravir. See: molnupiravir SPC
Antivirals not recommended in this group. 

 

Prescribing information

Drug interactions MUST be checked before prescribing nirmatrelvir / ritonavir as these can be significant.

In renal disease and dialysis, Infectious Diseases & Renal Specialists in NHS Highland recommend 

Use the Hospital prescription forms forms for Pharmacy supply for oral COVID antiviral medication.

Editorial Information

Last reviewed: 22/07/2024

Next review date: 29/08/2024

Author(s): Acute Medicine, Antimicrobial Management Team.

Version: 1

Approved By: Awaiting approval

Reviewer name(s): Dr D Scott, Clinical Director, Acute, A MacDonald, Area Antimicrobial Pharmacist.

Document Id: COVID121