{"id":24241,"date":"2025-05-20T12:20:15","date_gmt":"2025-05-20T10:20:15","guid":{"rendered":"https:\/\/www.biolife-publisher.it\/iji\/?p=24241"},"modified":"2025-05-20T12:20:15","modified_gmt":"2025-05-20T10:20:15","slug":"antimicrobial-resistance-during-the-pandemic","status":"publish","type":"post","link":"https:\/\/www.biolife-publisher.it\/iji\/antimicrobial-resistance-during-the-pandemic\/","title":{"rendered":"ANTIMICROBIAL RESISTANCE DURING THE PANDEMIC"},"content":{"rendered":"

Daliu P. Antimicrobial resistance during the pandemic. International Journal of Infection.<\/em> 2023;7(2):53-55.<\/p>\n

\n

P. Daliu*<\/sup><\/p>\n

Department of Pharmacy, University of Naples \u201cFederico II\u201d, Naples, Italy.<\/p>\n

*Correspondence to:<\/em>
\nPatricia Daliu,
\nDepartment of Pharmacy,
\nUniversity of Naples \u201cFederico II\u201d,
\n80131 Naples, Italy.<\/p>\n\n\n\n
Received: 02 June, 2023
\nAccepted: 31 July, 2023<\/p>\n

\"adobe-pdf-download-icon\"<\/a><\/td>\n

ISSN 1972-6945 [online]
\nCopyright 2023 \u00a9 by Biolife-publisher
\nThis publication and\/or article is for individual use only and may not be further reproduced without written permission from the copyright holder. Unauthorized reproduction may result in financial and other penalties. Disclosure: all authors report no conflicts of interest relevant to this article.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

KEYWORDS:<\/strong> Antimicrobial resistance, SARS-CoV-2, COVID-19, pandemic, antibiotic, infection<\/em><\/p>\n

 <\/p>\n

INTRODUCTION<\/strong><\/p>\n

 <\/p>\n

Antibiotics represent one of the most important discoveries in medicine, but their frequent use has caused an increase in antimicrobial resistance (AMR) which is very concerning.\u00a0 The excessive use of antibiotics has resulted in the development of resistance in microbes, comprising the efficacy of current antibiotics, which requires the generation of new ones, and if the phenomenon of bacterial resistance continues, antibiotic therapy will continue to become compromised.<\/p>\n

Over the past decades, many published scientific articles have highlighted the importance of increasing resistance to antibiotics and researchers emphasize the need for new approaches to find more effective antibiotics.\u00a0 In 2019 alone, AMR directly caused over 1 million deaths and contributed to the deaths of over 5 million individuals globally (1).\u00a0 In the US, AMR is the third leading cause of death after heart disease and cancer, which is a striking concern that urgently needs a solution. If this crisis is not immediately resolved, by 2050, there could be one million deaths.<\/p>\n

The study of AMR became more focused during the COVID-19 pandemic with SARS-CoV-2 infection. During the early stages of the pandemic, there was widespread use of antibiotics to treat secondary bacterial infections in patients infected with SARS-CoV-2, even though COVID-19 is caused by a virus, which resulted in a notable increase in resistance in many microorganisms (2,3).<\/p>\n

 <\/p>\n

DISCUSSION<\/strong><\/p>\n

 <\/p>\n

AMR is predominant in hospitals, where it creates significant problems. During the first year of the pandemic, about 40% of individuals with AMR infection died, in a population of 30,000 people, and most of these patients had been infected in hospitals (4).<\/p>\n

Microorganisms possess many mechanisms for developing resistance and have the ability to share them with other microorganisms (5).\u00a0 The battle against resistance began as early as the discovery of penicillin and has continued to this day with the excessive and nonspecific use of modern antibiotics. Antibiotics are also used in viral infections to combat bacterial superinfection, but excessive use can lead to AMR.<\/p>\n

During infection, an accurate diagnosis is essential to identify microbes and target resistant strains. Sometimes multiple unnecessary antibiotics are used while waiting for diagnostic tests, contributing to the phenomenon of resistance (6). And, once a broad spectrum of antibiotics is prescribed, there is generally a reluctance to de-escalate or deprescribe.<\/p>\n

In light of AMR, new antibiotics have been made available to the community such as cefiderol, ceftazidime-avibactam, delafloxacin, eravacycline, omadacycline, and plazomicin, amongst others, but this has not been enough to reduce AMR (7).\u00a0 However, despite these new antibiotic weapons, many hospitals have not included them in their protocols, perhaps because they are too expensive compared to standard antibiotics.<\/p>\n

During the COVID-19 pandemic, overuse and misuse of antibiotics contributed to the phenomenon of AMR (Fig.1). During the pandemic, healthcare systems were put under strain and many patients with COVID-19 were treated with antibiotics despite bacterial co-infections not always being present. Patients hospitalized for COVID-19 were at an increased risk of bacterial infection due to antibiotic-resistant bacteria, and resistant bacterial infections caused an overlap of symptoms caused by SARS-CoV-2, exacerbating the clinical picture. This also altered prescribing practices due to limited access to healthcare workers and may have led to more empirical antibiotic prescriptions (8).<\/p>\n

 <\/p>\n

\"\"<\/p>\n

Fig. 1.<\/strong> During the COVID-19 pandemic, antibiotics were often overused and misused, contributing to antimicrobial resistance (AMR).<\/em><\/p>\n

 <\/p>\n

CONCLUSIONS<\/strong><\/p>\n

 <\/p>\n

Experts in infectious diseases have long been concerned about the threat of AMR, which continues to rise and jeopardize the efficacy of antibiotic treatment. Despite research efforts, the fact that AMR continues to be growing is very worrying. During the pandemic, patients hospitalized with COVID-19 were at an increased risk of bacterial infection due to antibiotic-resistant bacteria, and were also often prescribed unnecessary antibiotics, which contributed to AMR.<\/p>\n

\u00a0<\/em><\/p>\n

\u00a0<\/em><\/p>\n

Conflict of interest <\/em><\/p>\n

The author declares that they have no conflict of interest.<\/p>\n

 <\/p>\n

REFERENCES<\/strong><\/p>\n

    \n
  1. Antimicrobial Resistance Collaborators. Global Burden of Bacterial Antimicrobial Resistance in 2019: a Systematic Analysis. The Lancet<\/em>. 2022;399(10325):629-655. doi:https:\/\/doi.org\/10.1016\/S0140-6736(21)02724-0<\/li>\n
  2. Abadi B, Ilaghi M, Shahsavani Y, Faramarzpour M, Oghazian MB, Rahimi HR. Antibiotics with Antiviral and Anti-Inflammatory Potential Against Covid-19: A Review. Current reviews in clinical and experimental pharmacology<\/em>. 2023;18(1):51-63. doi:https:\/\/doi.org\/10.2174\/2772432817666220106162013<\/li>\n
  3. Choudhury S, Medina-Lara A, Smith R. Antimicrobial resistance and the COVID-19 pandemic. Bulletin of the World Health Organization<\/em>. 2022;100(05):295-295A. doi:https:\/\/doi.org\/10.2471\/blt.21.287752<\/li>\n
  4. Lai CC, Chen SY, Ko WC, Hsueh PR. Increased antimicrobial resistance during the COVID-19 pandemic. International Journal of Antimicrobial Agents<\/em>. 2021;57(4):106324. doi:https:\/\/doi.org\/10.1016\/j.ijantimicag.2021.106324<\/li>\n
  5. Christaki E, Marcou M, Tofarides A. Antimicrobial Resistance in Bacteria: Mechanisms, Evolution, and Persistence. Journal of Molecular Evolution<\/em>. 2019;88(1). doi:https:\/\/doi.org\/10.1007\/s00239-019-09914-3<\/li>\n
  6. McEwen SA, Collignon PJ. Antimicrobial Resistance: a One Health Perspective. Microbiology Spectrum<\/em>. 2018;6(2). doi:https:\/\/doi.org\/10.1128\/microbiolspec.arba-0009-2017<\/li>\n
  7. Bassetti M, Magn\u00e8 F, Giacobbe DR, Bini L, Vena A. New antibiotics for Gram-negative pneumonia. European Respiratory Review<\/em>. 2022;31(166). doi:https:\/\/doi.org\/10.1183\/16000617.0119-2022<\/li>\n
  8. Tabah A, Buetti N, Barbier F, Timsit JF. Current opinion in management of septic shock due to Gram-negative bacteria. Current Opinion in Infectious Diseases<\/em>. 2021;34(6):718-727. doi:https:\/\/doi.org\/10.1097\/qco.0000000000000767<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

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