from the editor healthcarehygienemagazine
Tackling Antimicrobial Resistance in the Age of COVID-19
In this edition ’ s 2021 recap , we include highlights of the information coming out of the virtual IDWeek 10 th anniversary conference held this fall . One of the issues that was discussed most throughout the conference was the impact of the COVID-19 pandemic on antibiotic / antimicrobial stewardship .
As presenter Teena Chopra , MD , MPH , emphasized during her presentation , the dissemination of SARS-CoV-2 around the globe was followed by an increased consumption of antibiotics . This triggered concern about bacterial superinfections in COVID-19 patients , with difficulties in distinguishing COVID-19 from community-acquired pneumonia caused by bacteria when patients first arrive for inpatient healthcare services . She said that azithromycin prescribing in particular was higher than expected , especially in geographic areas with escalated numbers of COVID-19 cases . She added that this reflected the antibiotic ’ s early promotion as a potential therapy , despite its ineffectiveness against viruses .
Chopra explained that an increase in antibiotic use during the pandemic may cause adverse reactions such as Clostridioides difficile infections , with clinical disease ranging from diarrhea and fever to colitis . She said that antibiotic overuse increases the risk of emergence and transmission of multidrug-resistant bacteria , and that these infections are more difficult to treat and have increased morbidity and mortality associated with them . She pointed to guidance on acute co-infections with bacteria from the World Health Organization ( WHO ) which recommends against the use of antibiotic
therapy or prophylaxis for patients with suspected or confirmed mild COVID-19 . Additionally , WHO warms against antibiotics for patients with suspected or confirmed moderate COVID-19 unless there is clinical suspicion of a bacterial infection .
She said that WHO recommends the use of empiric antimicrobials to treat all likely pathogens , based on clinical judgment , patient host factors , and local epidemiology with suspected or confirmed severe COVID-19 . This should be done as soon as possible , ideally with blood cultures obtained first . She said that early and appropriate empiric antimicrobial therapy can be administered in the emergency department and / or pre-hospital setting , and the duration should be as short as possible , ideally five to seven days .
Chopra said it was critical to discriminate between viral and bacterial co-infection to avoid unnecessary antibiotics , pointing to the fact that by 2050 , antimicrobial resistance will be responsible for the death of 10 million people and could cost the U . S . healthcare system as much as $ 100 trillion . She emphasized , “ One of the main recommendations is to optimize antibiotic use by ensuring that the appropriate antibiotic is administered at the correct dose , for the correct duration , and in a manner that ensures the best outcome and limits side effects and antimicrobial resistance .”
Until next month , bust those bugs !
Kelly M . Pyrek Editor & Publisher kelly @ healthcarehygienemagazine . com
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