A feature in the BMJ highlights the threat of antimicrobial-resistance as many patients admitted to hospital with COVID-19 receive antibiotics to keep secondary bacterial infections at bay.
Little is known about how the pandemic is directly impacting overall levels of antimicrobial resistance (AMR). However, a data review from COVID-19 cases, mostly in Asia, found that more than 70 per cent of patients received antimicrobial treatment despite less than 10 per cent having bacterial or fungal coinfections.
The World Health Organization (WHO) recommends antibiotic use for only severe cases of COVID-19, at risk of secondary bacterial infections and death. “WHO continues to be concerned by the inappropriate use of antibiotics, particularly among patients with mild COVID-19,” states assistant director-general Hanan Balkhy.
One hospital in New York found a slow and steady increase in multidrug resistance among gram-negative bacteria.
Unsubstantiated claims regarding the effectiveness of antibiotics such as azithromycin against COVID-19 are also likely to contribute to shortages. Inadequate COVID-19 testing increases clinical uncertainty, and therefore it is initially unknown whether patients have concurrent bacterial infections.
“It will be interesting to see whether any change in profile occurred during the pandemic period,” states Balkhy.