Antibiotics overprescribed in pandemic, says WHO

BY MURIEL COZIER | 8 MAY 2024 | IMAGE: SHUTTERSTOCK

The World Health Organization (WHO) has said that there was widespread overuse of antibiotics in patients hospitalised by Covid-19.

The findings are based on data from the WHO Global Clinical Platform for Covid-19, a repository of standardised individual-level, anonymised clinical data from patients hospitalised with Covid-19. The data come from 450,000 patients in 65 countries between January 2020 and March 2023.

The WHO asserts that while only 8% of patients with Covid-19 had bacterial co-infections requiring antibiotics, 75% of patients were treated with antibiotics just in case they helped.

‘These data call for improvements in the rational use of antibiotics to minimise unnecessary negative consequences for patients and populations,’ said Silvia Bertagnolio, who heads the WHO’s unit head for surveillance, evidence and laboratory strengthening, in its AMR division.

The WHO notes that overall, antibiotic use did not improve clinical outcomes for patients with Covid-19, but rather that it might create harm for people without bacterial infection, compared with those not receiving antibiotics. ‘This underscores the urgent need to improve the rational use of antibiotics to minimise unnecessary negative consequences for both patients and populations,’ the WHO said.

Christopher Butler, a clinical researcher in common infections at the University of Oxford and the chief investigator of the PRINCIPLE and PANORAMIC trials investigating treatments for Covid-19 said: ‘Using antibiotics at scale for Covid-19, especially given results from more rigorous study designs, is likely to merely put patients at unnecessary risk of adverse events, waste resources and drive antimicrobial resistance.’

The news from the WHO comes as Wellcome, the global charitable foundation, says that vaccines have a role to play in tackling antimicrobial resistance. With vaccines helping to prevent the spread of infections in the first place, fewer infections mean a reduced use of antimicrobials, the charity says.

In its analysis, Wellcome cites research published in The Lancet Global Health (DOI: 10.1016/S2214-109X(23)00365-0) which indicates that H. influenzae b and S. pneumoniae vaccines dramatically reduced the burden of these diseases, and the incidence of resistant strains.

Charlie Weller, an infectious disease expert at Wellcome, noted: ‘Despite research showing that vaccines could play a significant role in combating many of the pathogens whose resistance to antimicrobials poses the greatest threat to human health, vaccines are rarely part of the antimicrobial resistance discussion.’