How has the COVID-19 pandemic impacted antimicrobial use (AMU) and antimicrobial resistance (AMR)? As more data become available, the picture is becoming clearer.
The COVID-19 pandemic dealt a heavy blow to health care systems around the world. As the number of patients with COVID-19 and secondary bacterial infections continued to rise sharply, experts in the global health community feared what the long-term impact of the crisis would be for already critical levels of antimicrobial resistance (AMR), especially in low- and middle- income countries.
Many assumed that AMR would increase substantially during the pandemic due to widespread changes in antimicrobial use (AMU). There were several factors to consider that impacted AMU, such as increased antibiotic use to treat (or prevent) secondary bacterial infections associated with COVID-19, along with incorrect prescribing of antibiotics for COVID-19 (a viral infection).
Conversely, increased attention to infection prevention and control measures (IPAC), and social distancing would lead to fewer infections and lower antimicrobial use. In addition to these factors, changes in the delivery of health services meant fewer people who needed antimicrobials were diagnosed or treated. With these and other dynamics to consider, research would be needed to understand the full impact of the COVID-19 pandemic on antimicrobial use and AMR.
In November 2022, the COVID-19 Evidence Network to support Decision-making (COVID-END) published its first in a series of reports to provide decision-makers with the best evidence to inform AMR research and policymaking in response to the COVID-19 pandemic. Using a living synthesis model allows for a rapid assessment of evidence while the pandemic continued but also provided an opportunity for regular updates to the evidence as new research and data becomes available. The latest update to the living synthesis was published in May 2023 and the next update is planned for November 2023. These analyses are jointly conducted by the AMR Policy Accelerator and the Knowledge Synthesis and Application Unit (KSAU) team at the University of Ottawa.