DOI: 10.5694/mja2.70241 ISSN: 0025-729X

Still Treating Yesterday's Risk? Reconsidering Antiviral Use for Mild‐to‐Moderate COVID ‐19 Cases in a Broadly Immune Population

Hadar Mudrik‐Zohar, Tim Cutfield, Susan Morpeth, Thomas Hills, Eamon Duffy, Laura J. Edwards, Allen C. Cheng, Steven Y. C. Tong

ABSTRACT

Antivirals for mild‐to‐moderate coronavirus disease 2019 (COVID‐19) were adopted for use based on trials in unvaccinated adults during the pre‐Omicron period. In today's broadly immune populations, where the risk of hospitalisation and death has decreased substantially, there is a lack of high‐quality contemporary evidence to support routine antiviral use for mild‐to‐moderate disease. Comparing the Australian and New Zealand experiences in the evolving COVID‐19 landscape highlights differences in policy and prescribing practice. Treatment guidelines should be informed by systematic evaluation of emerging data, given uncertainty regarding antiviral effectiveness in a context of widespread immunity and milder disease, which have altered the balance of risks and benefits.

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