A recent study highlights growing concerns regarding antimicrobial resistance. According to the World Health Organization’s statement on Friday, antibiotics were excessively used during the COVID-19 pandemic, contributing to the silent proliferation of antimicrobial resistance. Despite only eight percent of COVID-19 hospitalizations involving bacterial co-infections necessitating antibiotics, three-fourths of patients were prescribed these drugs as a precautionary measure against potential complications.
The study revealed that the highest antibiotic usage occurred among patients with severe or critical COVID-19 cases, reaching a global average of 81 percent. Particularly in the Eastern Mediterranean and African regions, antibiotics were widely prescribed, accounting for 83 percent of cases. These findings were derived from clinical data spanning 65 countries over a three-year period.
Of significant concern is the frequent prescription of “watch” antibiotics globally, which possess a higher potential for resistance, as highlighted by the study.
“The more we use, the more we lose,” said Dr Sangeeta Sharma, president of the Delhi Society for Promotion of Rational Use of Drugs. “When antibiotics — especially the strong ones — are used widely, they become ineffective. Increase in antibiotic resistance means stronger medicines are needed to treat the same infections subsequently. It also means that with increased resistance, more people die of infections, there are more complications and the hospital stays are longer,” she explained.
“When a patient requires antibiotics, the benefits often outweigh the risks associated with side effects or antibiotic resistance. However, when they are unnecessary, they offer no benefit while posing risks, and their use contributes to the emergence and spread of antimicrobial resistance,” said Dr Silvia Bertagnolio, WHO Unit Head for Surveillance, Evidence and Laboratory Strengthening, Division for AMR.
While the widespread use of antibiotics like Azithromycin became common during COVID-19, India’s overall antibiotic usage remains notably high. A survey conducted across 20 tertiary care hospitals nationwide by the National Centres for Disease Control revealed that 71.9 percent of patients received antibiotics. Surprisingly, 55 percent of these antibiotics were prescribed not for treating an infection but as a preventive measure.
Merely six percent of the antibiotics prescribed were aimed at addressing diagnosed infections; the remainder were empirically prescribed based on the physician’s assessment of potential infections. Dr. Sharma emphasized that individuals with viral infections should not be administered antibiotics. While doctors may prescribe antibiotics to prevent secondary bacterial infections in viral cases, evidence suggests they are ineffective in preventing such infections. Dr. Sharma added, “Secondary bacterial infections typically occur five to six days after the initial viral infection, so administering antibiotics from the onset of symptoms is a misallocation of resources.”
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