Does COVID-19 promote the spread of resistant bacteria?

Does COVID-19 promote the spread of resistant bacteria?

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More antibiotic resistant bacteria with COVID-19?

In times of corona crisis, medical centers in pandemic hotspots are often crowded. In the treatment and care of sick people, much more antibiotics are administered than normal, which promotes the spread of resistant bacteria, the warning in a recent article by the science magazine "Science".

The report concludes that the increased use of antibiotics in the wake of the COVID-19 pandemic is contributing to an increase in antibiotic-resistant strains of bacteria. Reliable data are currently still missing, but increasing resistance, particularly to antibiotics such as azithromycin, can be assumed.

Problems with the lungs are often treated with antibiotics

Antibiotics do not directly affect the respiratory virus SARS-CoV-2, which is responsible for COVID-19. But viral respiratory infections make it easier for bacteria to enter the body and often lead to bacterial pneumonia. It is difficult for medical professionals to determine which pathogens cause a person's lung problems. Such people are therefore often treated with antibiotics, especially when it comes to life and death.

Does an increase in COVID-19 patients lead to more resistant bacteria?

The researchers fear that the increase in COVID-19 patients could ultimately lead to an increase in antibiotic-resistant bacteria. Hospitals, especially intensive care units, are real breeding grounds for antimicrobial resistance. There are increasing efforts to curb the use of antibiotics. But COVID-19 complicates many of these efforts.

Does COVID-19 slow the spread of antibiotic resistance?

But there is also the thesis that the pandemic could slow down the spread of bacteria and antibiotic resistance within hospitals. Because many infections acquired in hospitals require operations, which are currently largely canceled in order to maintain bed capacity for COVID-19 patients. And the staff are currently wearing more masks and other personal protective equipment. However, some hospitals are forced to reuse personal protective equipment and to exchange ventilators between sufferers.

Transmission of pathogens in clinics

"It is very clear that COVID-19 is transmitted in hospitals, and if this is the case, this also applies to resistant bacteria," says Bo Shopsin of the Langone Health Center at the University of New York in the article by the scientific journal Science.

Use of antibiotics appears to be increasing rapidly

More importantly, the use of antibiotics appears to be increasing rapidly. Several recent studies from China indicate that almost all severe cases of COVID-19 are treated with antibiotics. According to the researchers, many U.S. and European doctors report the same thing.

Antibiotics necessary to fight secondary infections

Antibiotics are often actually necessary for treatment. There is increasing evidence that many COVID-19 patients die from secondary infections rather than from the virus itself. A recent study published in The Lancet on the results of 247 hospitalized COVID-19 patients in Wuhan, China, found that 15 percent of these patients and half of the deceased had bacterial infections.

Outbreaks of respiratory viruses favored fatal pneumonia

Larger outbreaks of other respiratory viruses make the researchers' concerns clear. Up to half of the 300,000 people who died of H1N1 flu in 2009, and the majority of deaths from the 1918 flu did indeed die from bacterial pneumonia.

Guidelines are not always applicable

Of course, there are guidelines on when antibiotics should and should not be used. But in the current situation, it is difficult to imagine that these guidelines will be fully complied with, the researchers emphasize. They explain the example of azithromycin.

Azithromycin Deficiency in the USA by COVID-19?

In combination with the malaria drug hydroxychloroquine, azithromycin is currently being used increasingly to treat COVID-19 patients after small, uncontrolled studies have indicated the effectiveness of the combination. It's almost impossible to know how often the combination is prescribed, but the rate is high enough to cause azithromycin deficiency in the United States, the researchers report.

Antibiotics less effective?

It is too early to say to what extent COVID-19 will affect global antibiotic resistance rates. But in some parts of the United States, even before the pandemic, 30 to 40 percent of some common types of bacteria were resistant to the class of drug to which azithromycin belongs, the researchers report. Now these or other antibiotics could become even less effective.

Do we need new guidelines?

Further research will examine the extent to which COVID-19 patients are given antibiotics and how often they suffer from secondary infections that justify the use of antibiotics. The results should help develop new guidelines for when and how antibiotics are prescribed. Providing patient records could also help to better understand how infections spread in hospitals and why bacterial and viral infections are linked. (as)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.


  • Sara Reardon: Antibiotic treatment for COVID-19 complications could fuel resistant bacteria, in Science (Published Apr 16, 2020), Science

Video: Antibiotic Resistance. Health. Biology. FuseSchool (December 2022).