WHO reports widespread overuse of antibiotics in hospitalised COVID-19 patients

New evidence from the World Health Organisation (WHO) indicates  extensive overuse of antibiotics during COVID-19 pandemic worldwide, potentially  exacerbating the “silent” spread of antimicrobial resistance (AMR).

The WHO statement informs that, while only 8 per cent of hospitalised patients with COVID-19 had bacterial co-infections requiring antibiotics, approximately  75 per cent of patients received antibodies prophylactically . Antibiotic usage ranged from 33 per cent  in the Western Pacific Region, to 83 per cent in the Eastern Mediterranean and the African Regions. Prescriptions decreased  in Europe and the Americas between 2020 and 2022, but  increased in Africa.

Highest rate of antibiotic usage was seen among patients with severe or critical COVID-19, with a global average of 81 per cent. In mild or moderate cases, there was a considerable variation across regions, with the highest use in the African Region (79 per cent).  

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.

Dr Silvia Bertagnolio, WHO Unit Head for Surveillance,  Evidence and Laboratory Strengthening, Division for AMR, emphasised the necessity of rational antibiotic use to minimise risks and antimicrobial resistance emergence and spread.

“These data call for improvements in the rational use of antibiotics to minimise unnecessary negative consequences for patients and populations,” adds Bertagnolio.

Overall, antibiotic use did not improve clinical outcomes for patients with COVID-19. But could harm those without bacterial infection, compared to non-receivers. This underscores the urgent need to improve the rational use of antibiotics.

A systematic evidence synthesis and appraisal will complement this work to inform upcoming WHO recommendations on antibiotic use in patients with COVID-19, as part of the guidelines for the clinical management of COVID-19.

“These findings underscore the important need to adequately resource the efforts to improve antibiotic prescribing globally, and are particularly relevant to discuss ahead of the upcoming UN General Assembly High-Level Meeting on AMR to take place 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 across human health, animal health, agri-food sectors and the environment, and to promote political leadership, financing and actions to slow the emergence and spread of AMR.