WHO flags antibiotic overuse in COVID-19 hospitalizations

By Francis Allan L. Angelo

The World Health Organization (WHO) has reported a significant overuse of antibiotics among patients hospitalized with COVID-19, potentially exacerbating the “silent” spread of antimicrobial resistance (AMR).

According to a recent study, while only 8% of these patients had bacterial co-infections that required antibiotics, approximately 75% were administered the drugs as a precautionary measure.

The use of antibiotics varied widely by region, from 33% in the Western Pacific to 83% in the Eastern Mediterranean and Africa. From 2020 to 2022, antibiotic prescriptions have declined in Europe and the Americas but have increased in Africa.

Patients with severe or critical COVID-19 saw the highest rates of antibiotic use, averaging 81% globally. In milder cases, the usage remained high at 79% in the African Region.

The study also found that ‘Watch’ antibiotics, which carry a higher risk of developing resistance, were the most frequently prescribed across all regions.

Dr. Silvia Bertagnolio, head of WHO’s Surveillance, Evidence and Laboratory Strengthening for AMR, emphasized the detrimental effects of unnecessary antibiotic use.

“When a patient requires antibiotics, the benefits often outweigh the risks. However, when they are unnecessary, they offer no benefit while posing risks, and their use contributes to the emergence and spread of antimicrobial resistance,” Bertagnolio said in a statement.

The findings, drawn from the WHO Global Clinical Platform for COVID-19 which collected data from around 450,000 hospitalized COVID-19 patients across 65 countries, revealed that antibiotic use did not improve clinical outcomes and could potentially harm patients without bacterial infections.

These insights were presented at the ESCMID Global Congress in Barcelona and will inform upcoming WHO recommendations on antibiotic use in COVID-19 patients. Dr. Yukiko Nakatani, WHO Assistant Director-General for AMR, highlighted the findings’ significance ahead of the UN General Assembly High-Level Meeting on AMR scheduled for September.

The meeting aims to foster global commitments to mitigate AMR across various sectors and promote concerted actions to manage its spread.