Clinical Infection in Practice (Nov 2023)
Multiorgan failure from excessive polypharmacy self-medication with prescription and non-prescription drugs following SARS-CoV-2 infection: A case report
Abstract
Background: The COVID-19 pandemic has led to unprecedented international collaboration with rapid vaccine development and rollout. In parallel, the public have been subjected to considerable publicity about unproven therapeutic agents, some of which are easily available, unregulated and can be purchased without prescription. This has encouraged the use of drugs without medical supervision with the potential for harm. Case report: A previously well patient in their sixth decade of life presented with a sepsis-like syndrome four weeks after SARS-CoV-2 infection with hypoglycaemia, lactic acidosis and multiorgan failure with cardiac, respiratory, hepatic, renal and haematological involvement. A polypharmacy overdose was the likely cause of the symptoms. The patient had reportedly taken courses of hydroxychloroquine, ivermectin and azithromycin in the preceding year, and in the week prior to admission was thought to have self-medicated with azithromycin, nimesulide, ivermectin and possibly several other drugs. Conclusion: Unregulated purchase of medications by vulnerable individuals to treat SARS-CoV-2 infection can lead to serious and even life-threatening consequences. The need to take a full drug history from any patient, including medicines purchased online or acquired from overseas, is paramount.
