This is what emerges from new findings from the World Health Organization: the highest rate of antibiotic use during the pandemic was observed among patients with severe or critical Covid-19, with a global average of 81%. In mild or moderate cases, there was considerable variation between regions, with the highest usage in the African region (79%).
29 APR –
Throughout the world during the Covid-19 pandemic there has been widespread overuse of antibiotics which may have exacerbated the “silent” spread of antimicrobial resistance (AMR).
This is what emerges from new data from the WHO global clinical platform for Covid-19 – an archive of standardized and anonymized clinical data at the individual level of patients hospitalized with Covid-19 – collected between January 2020 and March 2023, on around 450 thousand patients hospitalized for Covid-19 in 65 countries. The findings were presented in a WHO scientific poster shared at the ongoing ESCMID Global Congress in Barcelona.
WHO classifies antibiotics according to the AWaRe (Access, Watch, Reserve) classification, based on the risk of antimicrobial resistance. The study found that “Watch” antibiotics with higher resistance potential were prescribed more frequently globally.
While only 8% of hospitalized Covid-19 patients had bacterial co-infections that required antibiotics, three in four or about 75% of patients were treated with antibiotics “just in case” they helped. Antibiotic use ranged from 33% for patients in the Western Pacific region, to 83% in the Eastern Mediterranean and African regions. Between 2020 and 2022, prescriptions decreased over time in Europe and the Americas, while they increased in Africa.
The highest rate of antibiotic use was observed among patients with severe or critical Covid-19, with a global average of 81%. In mild or moderate cases, there was considerable variation between regions, with the highest usage in the African region (79%).
“When a patient needs antibiotics, the benefits often outweigh the risks associated with side effects or antibiotic resistance,” said Dr. Silvia Bertagnolio, WHO Head of Unit for Surveillance, Testing and Laboratory Strengthening, Antimicrobial Resistance Division – However, when they are not needed, they offer no benefit and their use contributes to the emergence and spread of antimicrobial resistance. These data call for improvements in the rational use of antibiotics to minimize unnecessary negative consequences for patients and populations.”
“Overall, the use of antibiotics has not improved clinical outcomes for patients with Covid-19 – highlights a WHO note – but rather, it could create harm for people without bacterial infection, compared to those who do not receive antibiotics . This highlights the urgent need to improve the rational use of antibiotics to minimize unnecessary negative consequences for both patients and populations. A synthesis and systematic evaluation of the evidence, warns a WHO note, will complete the work to inform upcoming WHO recommendations on the use of antibiotics in patients with Covid-19, as part of the guidelines for the clinical management of Covid -19”.
“These findings highlight the important need to adequately fund efforts to improve antibiotic prescribing globally and are particularly relevant to discuss ahead of the next UN General Assembly high-level meeting on antimicrobial resistance in September,” said Dr Yukiko Nakatani, WHO Deputy Director-General for Antimicrobial Resistance.
April 29, 2024
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