Increasing Consumption of Antibiotics during the COVID-19 Pandemic: Implications for Patient Health and Emerging Anti-Microbial Resistance

Shahana Seher Malik, Sunil Mundra

Research output: Contribution to journalReview articlepeer-review

36 Citations (Scopus)

Abstract

The emergence of COVID-19 infection led to the indiscriminate use of antimicrobials without knowing their efficacy in treating the disease. The gratuitous use of antibiotics for COVID-19 treatment raises concerns about the emergence of antimicrobial resistance (AMR). In this systematic review, we performed a thorough systematic search using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines of scientific databases (Scopus, Web of Science, and PubMed) to identify studies where antibiotics were prescribed to treat COVID-19 (December 2019 to December 2021). Of 970 identified studies, 130 were included in our analyses. Almost 78% of COVID-19 patients have been prescribed an antibiotic. Cephalosporins were the most prescribed (30.1% of patients) antibiotics, followed by azithromycin (26% of patients). Antibiotics were prescribed for COVID-19 patients regardless of reported severity; the overall rate of antibiotic use was similar when comparing patients with a severe or critical illness (77.4%) and patients with mild or moderate illness (76.8%). Secondary infections were mentioned in only 11 studies. We conclude that concerns related to COVID-19 and the lack of treatment strategy led to the overuse of antibiotics without proper clinical rationale. Based on our findings, we propose that antimicrobial stewardship should be retained as a priority while treating viral pandemics.

Original languageEnglish
Article number45
JournalAntibiotics
Volume12
Issue number1
DOIs
Publication statusPublished - Jan 2023

Keywords

  • AMR
  • COVID-19
  • antibiotics
  • cephalosporin
  • co-infection
  • secondary infection

ASJC Scopus subject areas

  • General Pharmacology, Toxicology and Pharmaceutics
  • Microbiology (medical)
  • Infectious Diseases
  • Pharmacology (medical)
  • Biochemistry
  • Microbiology

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