Implications of antibiotics use during the COVID-19 pandemic: present and future

Abstract

COVID-19 is caused by the SARS-CoV-2 virus, which has infected more than 4 million people with 278 892 deaths worldwide as of 11 May 2020. This disease, which can manifest as a severe respiratory infection, has been declared as a public health emergency of international concern and is being treated with a variety of antivirals, antibiotics and antifungals. This article highlights the administration of antimicrobials in COVID-19 patients worldwide, during the 2019–20 pandemic. It is imperative to be aware of the unreported amounts of antibiotics that have been administered worldwide in just a few months and a marked increase in antimicrobial resistance should therefore be expected. Due to the lack of data about antimicrobial use during this pandemic, the global impact on the emergence of new antimicrobial resistance is as yet unknown. This issue must be at the forefront of public health policymaking and planning in order that we are prepared for the potentially severe consequences for human and animal health and the environment.

Antimicrobial use in COVID-19 patients in the first phase of the SARS-CoV-2 pandemic: Rapid review and evidence synthesis

“…Moreover, the five most frequently prescribed antimicrobials (azithromycin, ceftriaxone, moxifloxacin, meropenem, piperacillin/tazobactam) are all classified as critically important antimicrobials (CIA) for human medicine. 31 Persistent use of those critically important antibiotics will provoke the emergence of MDR strains and a decline in the effectiveness of these compounds, 32 which poses a threat to survival rates from serious infections, neonatal sepsis and hospital infections, thus limiting the potential health benefits of surgery, transplants and cancer treatment. 33 A systematic review has also provided evidence on the emergence of antimicrobial resistance after mass azithromycin distribution for trachoma control programmes in Sub-Saharan Africa; macrolide resistance after azithromycin distribution was reported in three of the five organisms studied and there was little evidence for absence of resistance in Chlamydia trachomatis after azithromycin treatment, suggesting that Azithromycin may not remain effective for trachoma programmes.…”

Knowledge and Attitudes on Vaccination in Southern Romanians: A Cross-Sectional Questionnaire

“…A small number of respondents ( n = 3) mentioned antibiotics as an alternative to vaccination. While antibiotics and vaccines mostly have very different indications, use of antibiotics during the COVID-19 pandemic should be expected to increase levels of antimicrobial resistance in the medical, veterinary and environmental sectors [ 29 ].…”

Implications of COVID-19 Pandemic on the Emergence of Antimicrobial Resistance: Adjusting the Response to Future Outbreaks

“…Antibiotic treatments are mostly applied as prophylaxis to prevent further bacterial coinfections among hospitalized patients, but, in several countries, the common and extensive use of antimicrobials in the treatment of hospitalized COVID-19 patients is considered to be a part of the routine treatment package. Furthermore, it is possible that the amounts and types of antimicrobials used are currently under-documented and, thus, underestimated [ 32 , 33 ]. Additionally, the hype around premature reports of possible treatments for COVID-19 may also spike the prescription of antibiotics.…”