• Emma L Smith, Amanda Gwee, Jason A Roberts, James S Molton, Danielle Wurzel, Carly M Hughes, and Benjamin A Rogers.
• Monash Infectious Diseases, Monash Health, Melbourne, Victoria, Australia.
• Intern Med J. 2022 Feb 1; 52 (2): 214-222.

BackgroundThe COVID-19 pandemic has generated significant debate about how emerging infections can be treated in the absence of evidence-based therapies to combat disease. In particular, the use of off-label therapies outside of a clinical trial setting has been controversial.AimTo longitudinally study policies and prescribing practices pertaining to therapies for COVID-19 in Australian health services during 2020.MethodsProspective data were collected from participating Australian health services who may care for patients with COVID-19 via an electronic portal. A single informant from each health service was emailed a survey link at regular intervals. Information was sought regarding changes to COVID-19 policy at their service and use of therapies for COVID-19.ResultsOverall, 78 hospitals were represented from 39 respondents with longitudinal data collection from May to December 2020. All Australian states/territories were represented with the majority (34/39; 87%) of respondents located in a major city. Just over half (20/39) of respondents had a written policy for COVID-19 therapy use at their health service at survey enrolment and policies changed frequently throughout the pandemic. Therapy use outside of a clinical trial was reported in 54% of health services, most frequently in Victoria, correlating with higher numbers of COVID-19 cases. At study commencement, hydroxychloroquine was most frequently used, with corticosteroids and remdesivir use increasingly throughout the study period.ConclusionOur results reflect the reactive nature of prescribing of therapies for COVID-19 and highlight the importance of evidence-based guidelines to assist prescribers.© 2021 Royal Australasian College of Physicians.

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