Antibiotic overuse for COVID-19 was largely caused by lack of specific treatment (representative)
Many mistakes have been made in the use of antibiotics during the COVID-19 pandemic. We need to learn from them to curb the rise of antimicrobial resistance.
The rampant overuse of antibiotics during the COVID-19 pandemic, largely due to lack of knowledge, has fueled the rise of antimicrobial resistance, but at the same time has two implications for the future. It also provided important lessons.
Ironically, the overuse of antibiotics caused by the pandemic makes future bacterial or viral pandemics even more likely.
A key lesson reinforced by the pandemic was that antibiotic use needs to be rationalized, and to achieve that, medical professionals and the broader public need to understand why.
The overuse of antibiotics for the novel coronavirus disease (COVID-19) was largely due to the lack of specific treatments for the virus. Ignorance of causes and the rapid evolution of COVID-19 have given medical communities little time to formulate evidence-based strategies.
As a result, COVID-19 patients, with or without evidence of co-infection or secondary infection, are treated in vain, leading to increased health care costs, increased antibiotic resistance and, in some cases, increased mortality. Ta.
Antibiotics, such as antibiotics and antimycotics, are a cornerstone of modern medicine and an integral part of a sustainable healthcare system. Properly and fairly prescribed, it saves lives.
However, their misuse contributes to the development of resistance and unresponsiveness to available drugs, making some infections difficult to treat.
As a result, patients experience longer illness, longer hospital stays, higher treatment costs, and an increased risk of death.
The COVID-19 pandemic has accelerated the rate of increase in antimicrobial resistance, largely due to ignorance and fear.
The overuse of antibiotics in treating COVID-19 patients has hampered infection control and prevention practices in the healthcare system. The results have been devastating and have placed enormous strains on health care systems and financial resources.
In India, azithromycin use has surged with the spread of COVID-19, as most fever cases in patients with suspected COVID-19 were prescribed azithromycin, study shows .
The use of broad-spectrum agents, particularly carbapenems, was standard for hospitalized patients.
Scientific approaches to infection control have also been hampered by pandemic fear and ignorance of precautions.
To make up for the shortfall, doctors resorted to heavy use of antibiotics and antifungals. These measures were further facilitated by the evolving knowledge that fungal infections are more common in critically ill patients with COVID-19.
The doctors quickly learned their lesson. It would be prudent to apply these lessons now to prevent alarming rates of antimicrobial resistance in the future.
The only way to limit antimicrobial resistance in hospitals and communities is to instill a sense of responsible and rational use of antimicrobials.
It does so by educating and instilling awareness in communities and physicians about the issue.
Antimicrobial control practices need to be strengthened at all levels of the public health system.
Antibiotic management is a systematic effort to educate and persuade antimicrobial prescribers to follow evidence-based prescribing practices in order to prevent overuse and resulting antimicrobial resistance.
There is a need to close the gaps in current practice and application of antimicrobial management.
Most Indian public hospitals do not have infectious disease doctors, so clinicians with a passion for management can be trained for the role.
Physicians at all levels should be educated not to prescribe antibiotics without confirming a diagnosis of infection.
Investing in diagnostic routines such as quality laboratory and point-of-care diagnostics for bacterial, fungal and viral infections is critical.
During the COVID-19 pandemic, many antibiotics were prescribed to prevent secondary infections. Good infection control practices can encourage responsible prescribing by physicians and can be achieved in hospitals by good infection control teams.
Easily implemented and customized for low- and middle-income countries, the guidelines will ensure standardization of infection control practices in small hospitals, which make up the majority of facilities in countries like India.
There is a need to strengthen infection control and improve diagnostic management in hospitals.
A facility with an adequate antimicrobial management team can ensure proper prescribing and enhanced monitoring of multidrug-resistant organisms.
The World Health Organization’s Committee of Experts on the Choice and Use of Essential Medicines developed the AWaRe Classification of Antibiotics in 2017 as a tool to support antibiotic management efforts.
This classification classifies antibiotics into three groups: Access, Watch, and Reserve, emphasizes the importance of proper use, and considers the impact of different antibiotics on antimicrobial resistance.
It is a useful tool for monitoring antibiotic consumption, defining targets, and monitoring the effectiveness of control policies.
Physicians should be educated about the AWaRe classification and the risks of broad-spectrum antibiotic use.
The increasing use of broad-spectrum antibiotics is the result of a variety of factors.
These include lack of definitive diagnosis of disease-causing pathogens, increasing antimicrobial resistance to other classes of antibiotics, lack of availability of first-line penicillin antibiotics, and even marketing of pharmaceutical manufacturing. and even publicity.
Declining use of broad-spectrum antibiotics from AWaRe’s Watch and Reserve taxonomic groups by physicians does not bode well.
This practice may result in limited and more expensive treatment options for drug-resistant infections in Indian patients, leading to increased associated suffering and mortality.
It is also important to make antibiotic management part of undergraduate and graduate medical education.
As increasing antimicrobial resistance reduces the ability of antibiotics to treat infections, the threat of bacterial or viral pandemics with secondary bacterial infections resistant to available antimicrobial stocks remains. Powerful.
Investing in the health system to provide trained personnel, well-equipped laboratories, and raise awareness about the threat of drug-resistant superbugs is the only way to prevent an already severe crisis from becoming a pandemic.
Dr. Kamini Walia is a senior scientist at the Indian Medical Research Council’s Division of Epidemiology and Epidemics, New Delhi. She leads her ICMR her initiative on antimicrobial resistance.
Originally published under creative commons by 360 information.
