Why COVID-19 may complicate fight against antibiotic resistance

Many medical leaders have reported widespread antibiotic use for COVID-19 patients at their hospitals, which may contribute to rising rates of antibiotic resistance, according to the University of Minnesota's Center for Infectious Disease Research and Policy in Minneapolis.

Even though COVID-19 is caused by a virus, some clinicians resorted to using antibiotics due to clinical uncertainty and the risk of secondary bacterial infections among seriously ill patients.

"I think, undoubtedly, we've seen more antibiotic use, because sometimes clinicians are unsure … and there really are no effective treatments for COVID-19," Anurag Malani, MD, director of the infection prevention and antimicrobial stewardship programs at Ann Arbor, Mich.-based Saint Joseph Mercy Health System, told the website for the Center for Infectious Disease Research and Policy. 

COVID-19 testing delays also contributed to higher antibiotic use early in the pandemic. Instead of waiting several days for test results, many clinicians gave antibiotics to patients with symptoms of severe community-acquired pneumonia in case it was bacterial, according to Valerie Vaughn, MD, a hospitalist at Ann Arbor-based Michigan Medicine. 

When the pandemic begins to slow, hospitals in hard-hit states like Michigan and New York will have more time to review clinical data on COVID-19 patients. They should look at how many patients received antibiotics and, of those, how many got a secondary infection, according to Debbie Goff, PharmD, a pharmacist who specializes in antibiotic stewardship at The Ohio State University Wexner Medical Center in Columbus. From there, hospitals should identify the factors that put COVID-19 patients at risk of infection to promote more targeted antibiotic use, Dr. Goff said.

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