Key considerations on the potential impacts of the COVID-19 pandemic on antimicrobial resistance research and surveillance (original) (raw)
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Impact of COVID-19 on antimicrobial resistance: revealing the hidden threats
International journal of scientific reports , 2022
The COVID-19 pandemic, which was caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has impacted every area of life, including efforts concerning antibiotic resistance (AMR). Antibiotic usage in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) patients exceeded the incidence of bacterial coinfections and secondary infections during the COVID-19 pandemic, suggesting irrational and excessive prescribing. Even in settings with established antimicrobial stewardship (AMS) programs, weaknesses were seen regarding the optimal use and administration of antibiotics during the epidemic. This irrational use and prescribing threaten the future of antimicrobial use and imply the possibility of another pandemic caused by multidrug-resistant pathogens. In this review, we summarized the important aspects of COVID-19's impact, specifically on antimicrobials and other aspects. Antimicrobial stewardship programs are to be reinforced if not already implemented in all hospital settings to guide antimicrobial selection. This could contribute to combating this emerging concern of antimicrobial resistance.
Antimicrobial Resistance and Second Wave of COVID-19: Will It Impose Management Protocols Deviation?
2020
Antibiotics are widely used therapeutic agent in treatment of different infectious diseases either bacterial or fungal. Misuse of antibiotics and other social factors are of the main factor for emerging antibiotics resistant pathogenic stains. It was proven that the high mortality rates increased healthcare economical costs and reduced productivity are highly associated with antibiotic resistance. Currently, COVID-19 infection is at its first wave peak in some countries as American ones, at the same time an emerged second wave started in other countries as European countries which may last for further period of time globally. Investigations showed that healthcare systems are using antibiotics in management of all SARS-CoV-2 infections even if they are mild in symptoms although only 10% to 15% of the infected SARS-CoV-2 cases showed secondary bacterial infection due to difficulty in differentiation between viral and bacterial infection leading to antibiotic misuse. Besides, overwhelm...
2021
BackgroundAs the numbers of people with COVID-19 continue to increase globally, concerns have been raised regarding the widespread use of antibiotics for the treatment of COVID-19 patients and its consequences for antimicrobial resistance during the pandemic and beyond. The scale and determinants of antibiotic use in the early phase of the pandemic, and whether antibiotic prescribing is beneficial to treatment effectiveness in COVID-19 patients, are still unknown. Unwarranted treatment of this viral infection with antibiotics may exacerbate the problem of antibiotic resistance, while antibiotic resistance may render presumptive treatment of secondary infections in COVID-19 patients ineffective.MethodsThis rapid review was undertaken to identify studies reporting antimicrobial use in the treatment of hospitalised COVID-19 patients. The review was conducted to comply with PRISMA guidelines for Scoping Reviews (http://www.prisma-statement.org/Extensions/ScopingReviews) and the protocol...
Antibiotics
This scoping review aimed to explore the prevalence and patterns of global antibiotic use and bacterial infection in COVID-19 patients from studies published between June 2020 and March 2021. This review was reported in line with the Preferred Reporting of Systematic Reviews and Meta-Analyses (PRISMA) extension for Scoping Reviews, and the protocol is registered with the Open Science Framework. Compared with our previously-published review of the period (December 2019–June 2020), the antibiotic prescribing rate for COVID-19 patients (June 2020–March 2021) was found to have declined overall (82.3% vs. 39.7%), for mild and moderate patients (75.1% vs. 15.5%), and for severe and critical patients (75.3% vs. 48.3%). The seven most frequently prescribed antibiotics in COVID-19 patients were all on the “Watch” list of the WHO AWaRe antibiotics classification. The overall reported bacterial infection rate in COVID-19 patients was 10.5%, and the most frequently reported resistant pathogen i...
Antibiotics, 2021
This scoping review provides new evidence on the prevalence and patterns of global antimicrobial use in the treatment of COVID-19 patients; identifies the most commonly used antibiotics and clinical scenarios associated with antibiotic prescribing in the first phase of the pandemic; and explores the impact of documented antibiotic prescribing on treatment outcomes in COVID-19 patients. The review complies with PRISMA guidelines for Scoping Reviews and the protocol is registered with the Open Science Framework. In the first six months of the pandemic, there was a similar mean antibiotic prescribing rate between patients with severe or critical illness (75.4%) and patients with mild or moderate illness (75.1%). The proportion of patients prescribed antibiotics without clinical justification was 51.5% vs. 41.9% for patients with mild or moderate illness and those with severe or critical illness. Comparison of patients who were provided antibiotics with a clinical justification with tho...
Antimicrobial resistance during the COVID-19 pandemic: the missing patient perspective
JAC-Antimicrobial Resistance, 2021
While the use of antibiotics for secondary infections in COVID-19 has been described in scientific literature and guidelines have been issued for their appropriate use, the importance of listening to patients in a systematic manner has often been overlooked. To highlight this issue, we spoke with patients about their experiences with antibiotics as treatment for COVID-19 and their understanding of antimicrobial resistance (AMR). We found that there is a general lack of awareness of the risks of AMR, and even when patients are knowledgeable, fear of COVID-19 and pressure from healthcare providers often override considerations for appropriate use. We present case examples of three patients’ experiences and provide recommendations for health systems, healthcare providers, and patients or caregivers on actions they can each take to reduce the risk of AMR during and beyond the COVID-19 pandemic. We also share ways that the patient community can be empowered to provide their voices to dec...
Antibiotics, 2020
The coronavirus disease (COVID-19) pandemic, which has significant impact on global health care delivery, occurs amid the ongoing global health crisis of antimicrobial resistance. Early data demonstrated that bacterial and fungal co-infection with COVID-19 remain low and indiscriminate use of antimicrobials during the pandemic may worsen antimicrobial resistance It is, therefore, essential to maintain the ongoing effort of antimicrobial stewardship activities in all sectors globally.
Antibiotics
At the start of the COVID-19 pandemic, there was an increase in the use of antibiotics for the treatment of community-acquired respiratory tract infection (CA-ARI) in patients admitted for suspected or confirmed COVID-19, raising concerns for misuse. These antibiotics are not under the usual purview of the antimicrobial stewardship unit (ASU). Serum procalcitonin, a biomarker to distinguish viral from bacterial infections, can be used to guide antibiotic recommendations in suspected lower respiratory tract infection. We modified our stewardship approach, and used a procalcitonin-guided strategy to identify “high yield” interventions for audits in patients admitted with CA-ARI. With this approach, there was an increase in the proportion of patients with antibiotics discontinued within 4 days (16.5% vs. 34.9%, p < 0.001), and the overall duration of antibiotic therapy was significantly shorter [7 (6–8) vs. 6 (3–8) days, p < 0.001]. There was a significant decrease in patients wi...
COVID-19 and antibiotic resistance: Parallel pandemics and different intercessions
Microbes and Infectious Diseases
Coronavirus virus disease 2019 (COVID-19) is one of the challenges to the global public health. With COVID-19 impacts across all sectors, the most glaring one is its impact on antibiotic resistance, another silence pandemic. Antibiotic resistance is at a crossroads of becoming a major killer and the emergence of COVID-19 pandemic aggravate the threat, due to excessive and extensive use of antibiotics in the treatment package of COVID-19 despite being a viral pneumonia and for prophylaxis to prevent bacterial co-infection. Low bacterial co-infections were associated with COVID-19, but large antibiotics were employed, this challenged the principles of antibiotic stewardship, thus, further complicate the antibiotic stewardship guidelines. This review revolves to highlight the effect of COVID-19 pandemic and its impacts on bacterial co-infections as well as how it fuels the already existing silent pandemic; antibiotic resistance which is waiting to unleash its effect on public health and socioeconomic sectors. While there is increased focus on COVID-19 pandemic, the review urged that focus should not be taken off on antibiotic resistance.