Medical reversals in low- and middle-income countries.

Background: Low- to middle-income countries (LMICs) often have limited budgets for health care, and as such, they need to prioritize health care interventions that are evidence based. However, sometimes, interventions are implemented despite a lack of supporting evidence because of a perceived biologic plausibility or because they have worked in other populations. Later, some of these interventions are shown to either lack benefit or are harmful in randomized studies, which we call a medical reversal.

Main Body: In this paper, we discuss a variety of medical reversals in LMICs, ranging from tuberculosis to nutrition to malaria to septic shock. These practices were previously identified, but we wish to highlight those that are most relevant to LMICs.

Conclusion: Identifying and eliminating these practices will help in better allocation of limited health care resources and dollars in LMICs.