COVID-19 treatment could cause development of antimicrobial resistance

Scientists have shown through a study that patients with Covid-19 receiving treatment could eventually develop antimicrobial resistance.

The study goes to the extent of claiming that the use of antibiotics in people with COVID-19 could result in increased resistance to the drugs’ benefits among the wider population. How? According to the paper published in Journal of Antimicrobial Chemotherapy¬†the waste water discarded by patients’ bodies will end up in the water bodies around the world thereby¬†increasing the antimicrobial resistance (AMR), where bacteria become resistant to the action of antibiotics.

This would be particularly acute in receiving waters from waste water treatment works serving large hospitals, or emergency ‘Nightingale’ hospitals, where there is a concentration of COVID-19 patients.

The findings are based on reports that up to 95% of COVID-19 inpatients are being prescribed antibiotics as part of their treatment, and concerns that such a large-scale drug administration could have wider environmental implications.

The COVID-19 guidance issued by the National Institute for Health and Care Excellence (NICE) suggests patients with COVID-19 should be treated with doxycycline and either amoxicillin or a combination of other medications if a bacterial infection is suspected, but to withhold or stop antibiotics if a bacterial infection is unlikely.

Majority of patients in UK with COVID symptoms were prescribed antibiotics because it is very difficult to know whether a patient presenting with symptoms of COVID has an overlying bacterial infection or not. There wasn’t lot of work done to identify those patients who were unlikely to have a bacterial infection complicating their viral COVID infections in an attempt to reduce the amount of antibiotic exposure to our patients and consequently the environment.

This research combined patient numbers for UK emergency hospitals set up temporarily around the country with waste water treatment work capacity and available river water dilution serving the emergency hospital and associated town.

Using available environmental impact data and modelling tools developed by the UK water industry, it focussed on one UK emergency hospital – Harrogate, geared up to treat around 500 people – and showed the risks posed by doxycycline was low, assuming the hospital was at full capacity.

Amoxicillin is used to treat everything from pneumonia and throat infections to skin and ear infections.