Antibiotics won’t work on the COVID virus, but in places like India, their overuse threatens to nullify their effects on other equally deadly pathogens
Even before the COVID pandemic, antimicrobial resistance, in which microbes no longer respond to common medications like antibiotics, was a big concern for public health organizations and health care specialists. In 2019, the latest year for which data are available, antimicrobial resistance led to 4.95 million deaths globally, making it the third leading cause of death after cardiovascular diseases and cancer.
Take India, the largest consumer of antibiotics in the world, and a place where the culture of antibiotic use is deeply entrenched. Doctors prescribe an antibiotic for illnesses such as the common cold or diarrhea and even short fevers. These prescriptions are spurred by a variety of factors that include a lack of appropriate knowledge about when to use antibiotics, lack of diagnostics, inability of patients to afford diagnostics, economic incentives, patient demand and fear of clinical failure.
The COVID pandemic has aggravated this practice of antibiotic misuse. Despite COVID being a viral infection with low rates of secondary bacterial infection, the pandemic likely contributed to people in India taking about 216 million excess doses of antibiotics during the first wave in 2020. This, despite World Health Organization advice and the Indian government’s National Treatment Guidelines recommending against the use of antibiotics, especially for mild and moderate COVID cases.
Toward this, in 2017, the World Health Organization initiated the AWaRe framework for antibiotics, which classifies the drugs according to the risk of resistance arising. The WHO will soon release a reference book on antibiotics with simple infographics and a mobile app, which will provide best practices in clinical assessment, diagnosis and treatment of various infections in the outpatient and hospitalized patients using what’s called a traffic-light approach.
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