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WHO reports widespread overuse of antibiotics in patients hospitalized with COVID-19
New evidence from the World Health Organization (WHO) shows widespread overuse of antibiotics during the COVID-19 pandemic worldwide, which may have exacerbated the “silent” spread of antimicrobial resistance (AMR).
While only 8% of hospitalized COVID-19 patients had bacterial co-infections that required antibiotics, three out of four or about 75% of patients were treated with antibiotics 'just in case' to help. Antibiotic use ranged from 33% for patients in the Western Pacific region to 83% in the Eastern Mediterranean and African regions. Between 2020 and 2022, prescriptions decreased over time in Europe and the Americas, while increasing in Africa.
The highest rate of antibiotic use was observed among patients with severe or critical COVID-19, with a global average of 81%. In mild or moderate cases, there was considerable variation among regions, with the highest use in the African region (79%).
WHO classifies antibiotics according to the AWaRe (Access, Watch, Reserve) classification, according to the risk of AMR. Worryingly, the study found that 'Watch' antibiotics with higher resistance potential are the most commonly prescribed globally.
“When a patient needs antibiotics, the benefits often outweigh the risks associated with side effects or antibiotic resistance. However, when they are unnecessary, they offer no benefit while they pose a risk, and their use contributes to the emergence and spread of antimicrobial resistance,” said Dr. Silvia Bertagnolio, Head of WHO's Surveillance, Evidence and Laboratory Strengthening Unit, AMR Department.
“These data call for improvements in the rational use of antibiotics to reduce unnecessary negative consequences for patients and the population.”
Overall, the use of antibiotics did not improve clinical outcomes for patients with COVID-19. But it could harm people without a bacterial infection, compared to those who don't receive antibiotics. This highlights the urgent need to improve the rational use of antibiotics in order to minimize unnecessary negative consequences for both patients and the population.
A systematic evidence synthesis and assessment will complement this work to inform forthcoming WHO recommendations on the use of antibiotics in patients with COVID-19, as part of guidelines for the clinical management of COVID-19.
These findings are based on data from the World Health Organization's Global Clinical Platform for COVID-19, an individual-level repository of standardized anonymized clinical data from patients hospitalized with COVID-19. Data were collected from around 450,000 patients admitted to hospitals due to COVID-19 in 65 countries over a 3-year period between January 2020 and March 2023. The findings were presented in a WHO scientific poster shared at the ESCMID Global Congress- and which takes place in Barcelona, Spain from April 27 to 30.
“These findings highlight the important need for adequate funding of efforts to improve antibiotic prescribing globally, and are particularly relevant to the debate ahead of the upcoming UN General Assembly high-level meeting on antirheumatic residency this September,” said Dr. Yukiko Nakatani, WHO. Assistant Director General for AMR.
The UN High-Level Meeting on AMR will bring together global leaders to commit to mitigating AMR in human health, animal health, the agri-food sectors and the environment, and promote political leadership, funding and action to slow the emergence and spread of AMR -And. .
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