Antibiotics and antimicrobial resistance in the COVID-19 era: Perspective from resource-limited settings

Lucien, Mentor Ali Ber; Canarie, Michael F.; Kilgore, Paul E.; Jean-Denis, Gladzdin; Fénelon, Natael; Pierre, Manise; Cerpa, Mauricio; Joseph, Gerard A.; Maki, Gina; Zervos, Marcus J.; Dély, Patrick; Boncy, Jacques; Sati, Hatim; Rı́o, Ana del; Ramón-Pardo, Pilar

doi:10.1016/j.ijid.2020.12.087

Cited by 204 publications

(172 citation statements)

References 39 publications

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“…The coronavirus disease 2019 (COVID-19) pandemic has led to growing concern over an increased consumption of antimicrobials for COVID-19 patients, often inappropriately used, and its relation to potentially propagating antimicrobial resistance (AMR) in the short and long term [17,18]. This is particularly an issue in low-and middle-income countries (LMIC) as cost-effective, clinical or biologic markers that effectively discriminate between bacterial and viral infections are lacking [19]. The development of AMR can have a catastrophic impact on health systems in countries with low and middle income levels [20,21].…”

Section: Discussionmentioning

confidence: 99%

An Assessment of the Impact of Coronavirus Disease (COVID-19) Pandemic on National Antimicrobial Consumption in Jordan

et al. 2021

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Coronavirus disease 2019 (COVID-19) has overlapping clinical characteristics with bacterial respiratory tract infection, leading to the prescription of potentially unnecessary antibiotics. This study aimed at measuring changes and patterns of national antimicrobial use for one year preceding and one year during the COVID-19 pandemic. Annual national antimicrobial consumption for 2019 and 2020 was obtained from the Jordan Food and Drug Administration (JFDA) following the WHO surveillance methods. The WHO Access, Watch, and Reserve (AWaRe) classification was used. Total antibiotic consumption in 2020 (26.8 DDD per 1000 inhabitants per day) decreased by 5.5% compared to 2019 (28.4 DDD per 1000 inhabitants per day). There was an increase in the use of several antibiotics during 2020 compared with 2019 (third generation cephalosporins (19%), carbapenems (52%), macrolides (57%), and lincosamides (106%)). In 2020, there was a marked reduction in amoxicillin use (−53%), while the use of azithromycin increased by 74%. National antimicrobial consumption of the Access group decreased by 18% from 2019 to 2020 (59.1% vs. 48.1% of total consumption). The use of the Watch group increased in 2020 by 26%. The study highlighted an increase in the use of certain antibiotics during the pandemic period that are known to be associated with increasing resistance. Efforts to enhance national antimicrobial stewardship are needed to ensure rational use of antimicrobials.

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Section: Discussionmentioning

confidence: 99%

An Assessment of the Impact of Coronavirus Disease (COVID-19) Pandemic on National Antimicrobial Consumption in Jordan

et al. 2021

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“…A study indicated that 50% of patients who died from COVID-19 had bacterial pneumonia (79). It is prudent to use antibiotics for patients with severe COVID-19 (80).…”

Section: The Second Stage (Immune Response: Hyperactivation)mentioning

confidence: 99%

Cellular Immune Response to COVID-19 and Potential Immune Modulators

Zhou

2021

Front. Immunol.

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Coronavirus disease 2019 (COVID-19) is a respiratory infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Droplets and contacts serve as the main route of transmission of SARS-CoV-2. The characteristic of the disease is rather heterogeneous, ranging from no symptoms to critical illness. The factors associated with the outcome of COVID-19 have not been completely characterized to date. Inspired by previous studies on the relevance of infectious diseases, viral and host factors related to clinical outcomes have been identified. The severity of COVID-19 is mainly related to host factors, especially cellular immune responses in patients. Patients with mild COVID-19 and improved patients with severe COVID-19 exhibit a normal immune response to effectively eliminate the virus. The immune response in patients with fatal severe COVID-19 includes three stages: normal or hypofunction, hyperactivation, and anergy. Eventually, the patients were unable to resist viral infection and died. Based on our understanding of the kinetics of immune responses during COVID-19, we suggest that type I interferon (IFN) could be administered to patients with severe COVID-19 in the hypofunctional stage, intravenous immunoglobulin (IVIG) and glucocorticoid therapy could be administered in the immune hyperactivation stage. In addition, low molecular weight heparin (LMWH) anticoagulation therapy and anti-infective therapy with antibiotics are recommended in the hyperactivation stage.

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“…As most of the consumed drugs and their metabolites are excreted through urine and faeces, their discharge to aquatic environments depends on the removal efficiency of the WWTPs ( Singer et al, 2008 , Azuma et al, 2012 , Takanami et al, 2010 , Auerbach et al, 2007 , Kumar et al, 2020a ). If the WWTP clearing rate is low, microorganisms exposed to antimicrobials and metabolites develops mutations causing ADR ( Aali et al, 2014 , Alexander et al, 2020 , Guo et al, 2018 , Kumar et al, 2020a , Kumar et al, 2021 ) Thus, the increased use of antimicrobials in the current pandemic will probably pose an increased risk in terms of ADR during post COVID-19 as concerned by a number of recent studies (Kuroda et al, 2021; Lucien et al, 2021 ; Hsu, 2020 ; Kumar et al, 2020a ; Asaduzzaman et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Antidrug resistance in the Indian ambient waters of Ahmedabad during the COVID-19 pandemic

Kumar

Dhangar

Thakur

et al. 2021

Journal of Hazardous Materials

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The ongoing COVID-19 pandemic increases the consumption of antimicrobial substances (ABS) due to the unavailability of approved vaccine(s). To assess the effect of imprudent consumption of ABS during the COVID-19 pandemic, we compare the 2020 prevalence of antidrug resistance (ADR) of Escherichia coli ( E. coli ) with a similar survey carried out in 2018 in Ahmedabad, India using SARS-CoV-2 gene detection as a marker of ABS usage. We found a significant ADR increase for in 2020 compared to 2018 in ambient water bodies, harbouring a higher incidence of ADR E.Coli towards non-fluoroquinolone drugs. Effective SARS-CoV-2 genome copies were found to be associated with the ADR prevalence. The prevalence of ADR depends on the efficiency of WWTPs (Wastewater Treatment Plants) and the catchment area in its vicinity. In year 2018 study, prevalence of ADR was discretely distributed, and the maximum ADR prevalence recorded was ~60%; against the current homogenous ADR increase, and up to 85% of maximum ADR among the incubated E.coli isolated from the river (Sabarmati) and lake (Chandola and Kankaria) samples. Furthermore, wastewater treatment plants showed less increase in comparison to the ambient waters, which eventually imply that although SARS-CoV-2 genes and faecal pollution may be diluted in the ambient waters, as indicated by low C t -value and E.coli count, the danger of related aftermath like ADR increase cannot be nullified. Also, Non-fluoroquinolone drugs exhibited overall more resistance than the quinolone drugs. Overall, this is probably the first ever study that traces the COVID-19 pandemic imprints on the prevalence of antidrug resistance (ADR) through wastewater surveillance and hints at monitoring escalation of other environmental health parameters. This study will make public and policyholders concerned about the optimum use of antibiotics during any kind of treatment.

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Antibiotics and antimicrobial resistance in the COVID-19 era: Perspective from resource-limited settings

Cited by 204 publications

References 39 publications

An Assessment of the Impact of Coronavirus Disease (COVID-19) Pandemic on National Antimicrobial Consumption in Jordan

An Assessment of the Impact of Coronavirus Disease (COVID-19) Pandemic on National Antimicrobial Consumption in Jordan

Cellular Immune Response to COVID-19 and Potential Immune Modulators

Antidrug resistance in the Indian ambient waters of Ahmedabad during the COVID-19 pandemic

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