Recent findings from the World Health Organization (WHO) indicate widespread misuse of antibiotics across the globe during the COVID-19 pandemic, potentially worsening the unnoticed propagation of antimicrobial resistance (AMR).
Although only 8% of COVID-19 patients in hospitals had bacterial co-infections necessitating antibiotics, approximately 75% were administered antibiotics as a precautionary measure. The utilization of antibiotics varied widely, with rates ranging from 33% in the Western Pacific Region to 83% in the Eastern Mediterranean and African Regions. Over the period from 2020 to 2022, there was a decline in prescriptions in Europe and the Americas, while Africa witnessed an increase.
Patients classified as having severe or critical COVID-19 exhibited the highest antibiotic utilization rate globally, averaging 81%. For those with mild or moderate cases, there was significant regional disparity, with the African Region showing the highest usage at 79%.
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The World Health Organization (WHO) categorizes antibiotics based on the AWaRe (Access, Watch, Reserve) classification, which assesses the risk of antimicrobial resistance (AMR). Alarmingly, the research revealed that globally, ‘Watch’ antibiotics, which pose a higher risk of resistance, were the most commonly prescribed.
Dr. Silvia Bertagnolio, WHO Unit Head for Surveillance, Evidence, and Laboratory Strengthening in the Division for Antimicrobial Resistance (AMR), emphasized the importance of carefully weighing the benefits and risks of antibiotics for patients. While antibiotics are beneficial when needed, the unnecessary use of antibiotics poses risks without offering any benefits and contributes to the emergence and spread of antimicrobial resistance.
This data underscores the need for enhancements in the prudent utilization of antibiotics to reduce avoidable adverse outcomes for both individual patients and broader populations.
In general, the administration of antibiotics did not enhance clinical outcomes for individuals with COVID-19. Instead, it could potentially cause harm to those without bacterial infections compared to those who did not receive antibiotics. This highlights the critical necessity of enhancing the judicious use of antibiotics to mitigate unnecessary adverse effects for both patients and communities.
A systematic review and analysis of evidence will supplement this effort, aiding in the formulation of forthcoming WHO guidelines regarding antibiotic utilization in COVID-19 patients, as an integral component of the clinical management guidelines for the disease.
The conclusions stem from information gathered from the WHO Global Clinical Platform for COVID-19, which houses standardized, anonymized clinical data from individuals hospitalized with COVID-19. These insights are drawn from data collected from approximately 450,000 patients admitted to hospitals for COVID-19 across 65 countries during a span of three years, from January 2020 to March 2023. These findings are currently being showcased through a scientific poster presented by the WHO at the ESCMID Global Congress held in Barcelona, Spain, from April 27 to April 30.
Dr. Yukiko Nakatani, WHO Assistant Director-General for Antimicrobial Resistance (AMR), emphasized the critical necessity of sufficiently funding initiatives aimed at enhancing global antibiotic prescribing practices. These findings are especially pertinent for discussion leading up to the upcoming UN General Assembly High-Level Meeting on AMR scheduled for this September.
The UN High-Level meeting on Antimicrobial Resistance (AMR) will convene international leaders to pledge efforts toward mitigating AMR across various sectors, including human health, animal health, agri-food industries, and the environment. The meeting aims to foster political leadership, secure financing, and implement measures to decelerate the rise and dissemination of AMR.
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