WHO raises concerns about overuse of antibiotics

The World Health Organization (WHO) said on Friday that there was widespread misuse of antibiotics throughout the global COVID-19 pandemic that has potentially fuelled the propagation of antimicrobial resistance (AMR).

While only eight percent of hospitalized patients with COVID-19 had bacterial co-infections requiring antibiotics, three out of four patients were given them, “just in case” they helped.

“The advice was very clear right from the start. This was a virus. So it wasn't that that there was a guidance or recommendation that clinicians go in this direction,” said Dr Margaret Harris, WHO spokesperson, at a news briefing at UN Geneva. “But perhaps because people were dealing with something completely new, they were looking for whatever they thought might be appropriate.”

Antibiotic use ranged from 33 per cent for patients in the Western Pacific Region to 83 per cent in the Eastern Mediterranean and the African Regions. Between 2020 and 2022, prescriptions decreased over time in Europe and the Americas, while they increased in Africa.

The highest rate of antibiotic use 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, at 79 per cent.

“The only time you would use antibiotics when you've got a viral infection is if you had a secondary, proven, bacterial infection that was sensitive to those antibiotics,” said Dr. Harris. “So in other words, there were not being used appropriately. […] The main harm, of course, is that if you are using antibiotics, you're unnecessarily you're increasing the likelihood of antimicrobial resistance to those particular antibiotics so that when you do need them for your bacterial infection, they are no longer so useful.”

WHO said it was concerning that its study found that the antibiotics used had higher antimicrobial resistance potential than others that were available.

“If you give somebody a medication that they don't actually need, you are always exposing them to an unnecessary risk,” explained Dr. Harris. “Every time you treat a person for any illness with any medication, a doctor will balance will this medication do the job and prevent whatever the disease is and is that a more important outcome than any of the potential risks.”

These findings are based on data from the WHO Global Clinical Platform for COVID-19, an anonymized clinical data from patients hospitalized with COVID-19.

Data was collected from some 450. 000 patients admitted to hospitals for COVID-19 in 65 countries over a three-year period between January 2020 and March 2023.

The findings are being presented at the European Society of Clinical Microbiology and Infectious Diseases Global Congress, taking place in Barcelona, Spain from 27 to 30 April.