WHO warns about excessive use of antibiotics during the covid-19 pandemic

The excessive use of antibiotics during the covid-19 pandemic may have worsened the problem of resistance to these drugs, new data from the World Health Organization (WHO) reveals.

According to the entity, although only 8% of patients hospitalized with SARS-CoV-2 infection had bacterial co-infections that required the use of antibiotics, around 75% of them — equivalent to three out of every four patients — were treated with these. medicines.

People with severe and critical illness were those who received the most antibiotics. In this group, the global average of use was 81%. In mild and moderate cases, there was significant regional variation, with Africa being the region with the highest use, reaching 79%.

The data also indicates other important geographic differences. While 33% of patients in the Western Pacific used antibiotics in the context of hospitalization for Covid-19, this figure reached 83% in the Eastern Mediterranean and Africa.

Over time, between 2020 and 2022, there was a reduction in prescriptions in Europe and the Americas, but an increase in Africa.

The work showed that, in general, patients with covid-19 treated with antibiotics did not have better clinical results for the disease. The WHO also warned that the systematic prescription of these medications “may create harm for people without bacterial infections, compared to those who do not receive antibiotics”.

“When a patient requires antibiotics, the benefits often outweigh the risks associated with side effects or antibiotic resistance. However, when they are unnecessary, they offer no benefit, while at the same time they pose risks, and their use contributes to the emergence and spread of antimicrobial resistance,” said Dr. Silvia Bertagnolio, head of the Surveillance, Evidence and Strengthening Unit of WHO Laboratories.

“These data require improvements in the rational use of antibiotics to minimize unnecessary negative consequences for patients and populations,” he added.

The WHO survey also indicated that the majority of prescriptions, globally, were for antibiotics with the potential to increase antimicrobial resistance, which makes, in the experts’ assessment, the result even more alarming.

The WHO classifies antimicrobial resistance as one of the main global threats to public health. Excessive or inappropriate use of these medications in humans, plants and animals is the main factor for the development of more resistant pathogens.

Worldwide, it is estimated that bacterial resistance was directly responsible for 1.27 million deaths and contributed to another 4.95 million deaths in 2019, the year with the most up-to-date data.

The work considered information from around 450,000 patients, in 65 countries, hospitalized due to Covid-19 between January 2020 and March 2023. The data came from the global clinical data collection network on Covid-19 created by the WHO .

The conclusions were presented in a scientific poster by the organization at the Global Congress of European Society of Clinical Microbiology and Infectious Diseases (ESCMID), held in Barcelona, ​​Spain, from April 27th to 30th.

“These findings highlight the important need for adequate resources for efforts to improve antibiotic prescribing globally, and are particularly relevant for discussion ahead of the upcoming UN General Assembly High-Level Meeting on AMR [resistência antimicrobiana]which will take place in September,” said Dr. Yukiko Nakatani, WHO Assistant Director-General for AMR.

The United Nations meeting on the topic will bring together leaders from around the world with the aim of reaching a global commitment to reducing antimicrobial resistance, in addition to increasing funding for research and public policies.