S. Africa to administer Dexamethasone drug in COVID-19 treatment

South African Health Minister Dr Zweli Mkhize.


South African Health Minister Dr Zweli Mkhize. /REUTERS 

Early this week the United Kingdom announced the breakthrough research of the recovery trial  from Oxford University in Britain with regards to the treatment of COVID-19 patients using dexamethasone.

In the trial, they studied the therapeutic effects of dexamethasone, an anti-inflammatory
medicine well known in the clinical setting to manage inflammatory processes that are seen
in clinical setting such as asthma, allergic reactions, auto-immune disease and brain
swelling (oedema).

The drug was found to reduce mortality by one third in patients who required ventilatory support and by one fifth in patients who required non invasive supplementary oxygen.

The minister for health in South Africa, Dr. Zwelini Mkhize now says since that announcement, they have looked into their own context and found that they are indeed in a favourable position

“Our health care workers are very familiar with dexamethasone, having used it for decades
as a registered medicine in South Africa.We are immediately able to offer all patients that 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,” the minister submitted.

He further said that it is a significant breakthrough in evidence based management of COVID-19. The study results are compelling because it was a randomized study that was able to recruit large numbers of participants (6425).

“There is no other medicine that has shown this level of efficacy against COVID-19 to date.
The study showed no benefit for those patients who did not require oxygen supplementation,” he said.

The minister added that: “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.”

“Our 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.”

Dexamethasone is not recommended for asymptomatic patients or patients with symptoms
who do not require oxygen.

“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.”

South Africa says it will therefore be moving ahead to issue guidelines for the use of dexamethasone in all it’s facilities for desperately ill COVID-19 patients.