The World Health Organization (WHO) has expressed alarm regarding the widespread use of antibiotics in Covid-19 cases, which may have exacerbated antimicrobial resistance (AMR). AMR occurs when bacteria, viruses, fungi, and parasites no longer respond to antimicrobial medicines like antibiotics, rendering them ineffective against infections.
Dr. Silvia Bertagnolio, the WHO unit head for surveillance, emphasized the need for improvements in antibiotic prescription and use to minimize unnecessary negative consequences for patients and populations.
According to the WHO, while only 8% of hospitalized Covid-19 patients had bacterial coinfections necessitating antibiotics, about 75% were administered antibiotics “just in case” they would be helpful. This approach varied significantly across regions, with antibiotic use ranging from 33% to 83%.
Antibiotics Can Do Harm Without Bacterial Infections
The WHO classifies antibiotics into three groups – Access, Watch, Reserve – based on their potential to spread AMR. Watch antibiotics with higher resistance potential were most frequently prescribed globally during the pandemic, including antibiotics like ceftriaxone and meropenem.
The study conducted by the WHO revealed that overall, antibiotic use did not improve clinical outcomes for Covid-19 patients but rather might create harm for people without bacterial infection. Dr. Bertagnolio noted that when antibiotics are unnecessary, they offer no benefit while posing risks and contributing to the emergence and spread of antimicrobial resistance.
Observations from Phillipines
In the Philippines, data from the National Philippine Antimicrobial Use Point Prevalence Survey indicated prevalent antibiotic use for various conditions, including Covid-19, pneumonia, and other infections. Ms. Johanna Mallari Abella of the Department of Health (DOH) pharmaceutical division highlighted the high prevalence of antibiotic consumption leading to “very alarming rates of resistance among various pathogens”. These pathogens, including Escherichia coli (E. coli), Klebsiella pneumoniae (K. pneumoniae), Pseudomonas aeruginosa (P. aeruginosa), and Acinetobacter baumannii (A. baumannii), are associated with a range of infections like pneumonia, bloodstream infections, meningitis, urinary tract infections, and other infectious diseases.
AMR is a Global Public Health Threat
Globally, antimicrobial resistance is considered one of the top public health threats, responsible for millions of deaths annually. In the Philippines alone, AMR-related deaths were reported to be substantial in 2019. Ms. Abella reiterated the DOH’s advice against self-medication and the use of antibiotics without consulting a doctor to prevent the spread of AMR.
WHO: World Health Organization; AMR: Antimicrobial Resistance; DOH: Department of Health
E. coli: Escherichia coli; K. pneumoniae: Klebsiella pneumoniae; P. aeruginosa: Pseudomonas aeruginosa; A. baumannii: Acinetobacter baumannii
Adapted from: https://www.straitstimes.com/world/who-alarmed-by-high-use-of-antibiotics-in-covid-19-cases
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