An ampoule of Dexamethasone is seen in this picture illustration
An ampoule of Dexamethasone is seen in this picture illustration

SA to move ahead with dexamethasone treatment for critically ill Covid-19 patients

By IOL Reporter Time of article published Jun 19, 2020

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Durban - National Health Minister Dr Zweli Mkhize, has announced that dexamethasone will be used to treat critically ill Covid-19 patients. The administration of dexamethasone to desperately ill patients will bolster the country's fight against the virus that has claimed the lives of more than 1700 people in SA. 

On Friday, Mkhize said the department will be moving ahead with the issuing of guidelines for the use of dexamethasone in all our facilities for desperately ill Covid-19 patients.

"We are so pleased that we have the means to deliver quality, evidence-based health care to those who need it the most," Mkhize said. 

Earlier in the week, the Ministry announced a breakthrough of a recovery trial from the Oxford University in Britain which showed that dexamethasone had reduced the mortality rate by one third in patients on ventilators and by one fifth in patients who required oxygen. 

"This is a significant breakthrough in evidence-based management of Covid-19. The study results are compelling because it was a randomised study that was able to recruit large numbers of participants. There is no other medicine that has shown this level of efficacy against Covid-19 to date," he said. 

Mkhize said the country's health care workers were familiar with dexamethasone, having used it for decades as a registered medicine in South Africa. 

"We are immediately able to offer all patients who need intravenous dexamethasone. We have checked our stock and we currently have around 300 000 ampoules in the country. This is one of those medicines where we do have excellent local capacity. There are three major suppliers of intravenous dexamethasone in the country. 

"One of the companies manufactures the oral equivalent and supplies it all over the world and so we are able to negotiate the security of our own supply right here at home. In fact, to have a South African enterprise be a manufacturer and supplier of a critical medicine, especially one that will prove to be lifesaving in the current global context, is a real departure from the norm and so South Africans can take pride in being one of the countries that will provide a solution to a global crisis," he said. 

Mkhize said the Ministerial Advisory Committee on Covid-19 issued an advisory to recommend the use of dexamethasone (or an equivalent steroid like hydrocortisone or prednisolone) for all Covid-19 patients on ventilators or requiring non-invasive supplementary oxygen. 

He said dexamethasone is not recommended for asymptomatic patients or patients with symptoms who do not require oxygen. 

"This breakthrough is excellent news for us and we are especially fortunate that it came as we are preparing for our upcoming surge. The strategy is easy to implement as the medicine is inexpensive, easy to transport, easy to administer and will not require too much additional training. Whilst the MAC has made it clear their advisory is issued while awaiting the full study paper for closer assessment, we have learnt that leading clinicians in academic hospitals have been using the medicine and they are very excited that their anecdotal experiences have now been affirmed by higher levels of evidence," he said. 


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