Abstract
As of 23 April 2021, the outbreak of COVID-19 claimed around 150 million confirmed cases with over 3 million deaths worldwide. Yet, an even more serious but silent pandemic, that of antimicrobial resistance (AMR), is likely complicating the outcome of COVID-19 patients. This study discusses the current knowledge on the emergence of the SARS-CoV-2 and highlights the likely contribution of the COVID-19 pandemic on the escalation of AMR. COVID-19 engenders extensive antibiotic overuse and misuse, and will undoubtedly and substantially increase AMR rates worldwide. Amid the expanding COVID-19 pandemic, policymakers should consider the hidden threat of AMR much more, which may well be enhanced through improper use of antibiotics to treat patients with severe COVID-19 infection.
Highlights
Wuhan institute of Biological ChinaApproved in several countries and by the WHO reinfection rates (i.e., escape from natural immunity), disease severity and vaccine effectiveness (i.e., escape from vaccine-induced immunity)
Multisectoral, coordinated and targeted research on antimicrobial resistance (AMR) and in line with the One Health approach is required for containment of the challenges arising from AMR in the context of COVID-19 pandemic or upcoming threats
The COVID-19 pandemic is highly interrelated, multisectoral and there are no geographic or income boundaries to contain it. This pandemic has evidenced the multidimensional repercussions of an uncontrolled infectious disease, a situation that is comparable to what has already been predicted for AMR
Summary
Approved in several countries and by the WHO reinfection rates (i.e., escape from natural immunity), disease severity and vaccine effectiveness (i.e., escape from vaccine-induced immunity). Considering that COVID-19 is caused by a virus that leads to a self-limiting infection in the majority of cases, antibiotic treatment implemented in COVID-19 patients, especially when secondary bacterial infections are not laboratory confirmed, are indicative of a well-recognized global pattern of antibiotic misuse that has contributed to AMR emergence and spread [6]. Given the current absence of any COVID-19-specific therapeutics, the combination of hydroxychloroquine and azithromycin has since been extensively used compassionately in Italy, for instance, albeit without any firm evidence of clinical efficacy This bears the risk that azithromycin, a broad-spectrum macrolide antibiotic, which is primarily used in the treatment of respiratory, enteric and sexually transmissible infections caused by an assortment of extra- and intracellular pathogens such as Streptococcus pneumoniae, Haemophilus influenzae, Salmonella spp., Neisseria gonorrheae, among others [39] will be massively administered for the COVID-19 management. AMR is projected to become the leading cause of mortality worldwide with 10 million deaths yearly and cost up to US$ 100 trillion
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