New evidence from the World Health Organization (WHO) shows the extensive overuse of antibiotics during COVID-19 pandemic worldwide, which may have exacerbated "silent" spread of antimicrobial resistance (AMR).
While only 8% of hospitalized patients with COVID-19 had bacterial co-infections requiring antibiotics, three out of four or some 75% of patients have been treated with antibiotics ‘just in case’ they help. Antibiotic use ranged from 33% for patients in the Western Pacific Region, to 83% in the Eastern Mediterranean and the African Regions. Between 2020 and 2022, prescriptions decreased over time in Europe and the Americas, while they increased in Africa.
Highest rate of antibiotic use was seen among patients with severe or critical COVID-19, with a global average of 81%. In mild or moderate cases, there was a considerable variation across regions, with the highest use in the African Region (79%).
WHO classifies antibiotics as per AWaRe (Access, Watch, Reserve) classification, according to the risk of AMR. Concerningly, the study found that ‘Watch’ antibiotics with higher resistance potential were most frequently prescribed globally.
Overall, antibiotic use did not improve clinical outcomes for patients with COVID-19. But rather, it might create harm for people without bacterial infection, compared to those not receiving antibiotics. This underscores the urgent need to improve the rational use of antibiotics to minimize unnecessary negative consequences for both patients and populations.
These findings are based on data from the WHO Global Clinical Platform for COVID-19, a repository of standardized individual-level, anonymized clinical data from patients hospitalized with COVID-19. Data was collected from some 450 000 patients admitted to hospitals for COVID-19 in 65 countries over a 3-year period between January 2020 to March 2023.
