In a media briefing on June 1, the director-general of the World Health Organization (WHO), Tedros Adhanom Ghebreyesus, voiced the agency’s concerns over the misuse of antibiotics in treating the coronavirus.
“The COVID-19 pandemic has led to an increased use of antibiotics, which ultimately will lead to higher bacterial resistance rates that will impact the burden of disease and deaths during the pandemic and beyond,” he said, reports CBC Canada.
Canadian microbiologist Eric Brown, a professor at McMaster University’s Institute of Infectious Disease Research, is also concerned over the potential for the COVID-19 pandemic to drive up antibiotic resistance in bacteria. “The biggest concern is for those who have COVID-19 who maybe don’t need an antibiotic,” he said.
A common complication of severe viral infections
The Philadelphia Inquirer points out that a common complication of viral infections such as the flu or the coronavirus is a secondary, superimposed bacterial infection, or super-infection. These super-infections are often resistant to most antibiotics, including ones used earlier during treatment.
Interestingly, this problem is not discussed outside hospitals, but it is not a surprise for infectious disease experts. Even though the Spanish Flu pandemic of 1918 is long past, several studies have shown that many deaths were caused by secondary bacterial infections.
One study, published in 2007 in the Oxford Journal of Infectious Diseases, showed that many deaths were caused by secondary bacterial infections that began as a severe acute viral infection that spread down the respiratory tree, causing severe tissue damage that often resulted in a secondary bacterial invasion.
“Up to 50% of the deaths of people hospitalized on ventilators so far are actually a consequence of bacterial superinfections,” said Julie Gerberding, Merck and Co. chief patient officer and former director of the U.S. Centers for Disease Control and Prevention. “It’s a force of mortality that we need to pay more attention to.”
The long-term ramifications associated with the increased use of antibiotics in treating COVID-19 patients are still not fully known. Brown suggests the practice could jeopardize the use of antimicrobials to prevent infections after surgeries like hip replacements, C-sections, and organ transplants if bacteria in patients are resistant to them.
The bottom line? In treating a viral infection, regardless of it being the flu or the coronavirus, physicians need to be careful in using any antibiotic – especially if no secondary bacterial infection is present.
