Antibiotic Overprescribing Intensifies During COVID Pandemic

Covid-19 pneumonia is a viral pneumonia. We know this is not treatable with antibiotics, which only kill bacteria, not viruses.

Severe viral pneumonia can (sometimes) develop into a secondary bacterial infection, which is presumably why antibiotics are being used for virtually everyone with Covid-19.

Antibiotic Overprescribing Intensifies During COVID Pandemic 1

This doesn’t make prescribing antibiotics the right thing to do however. Antibiotics can cause harm and should be used with caution, especially in a patient with a severe viral infection.

“New data suggest that efforts to curb antibiotic overprescribing have taken a step backward during the COVID-19 pandemic, according to the Society for Healthcare Epidemiology of America.”

Long before Covid-19, the CDC had published that about 1/3 of all antibiotic prescriptions in the United States are unnecessary. This figure is very likely underestimated.

https://www.healio.com/primary-care/infectious-diseases/news/online/%7Be6cc6d91-5dbf-4381-a106-1d7dfbd3f6c6%7D/qa-antibiotic-overprescribing-intensifies-during-covid-19-pandemic

Doctors frequently feel pressure to find solutions for patients, so if there is a chance that somebody has a bacterial infection, even a small chance, then antibiotics will generally be prescribed, with few exceptions.

Very few doctors fully cooperate with the CDC’s recommendations to stop prescribing antibiotics inappropriately, and this is in spite of the serious health implications and the emergent problem of the development of antibiotic resistance.

Fewer and fewer antibiotics work the way they used to due to the emergence of bacteria that have acquired the ability to survive in their presence. We have trained bacteria to behave this way, and the more we use antibiotics the greater the burden of antibiotic resistance.

This is true even when we use antibiotics properly. But since such a great number of antibiotic prescriptions are inappropriate (used for viral infections), scientists are increasingly burdened with having to develop new antibiotics faster and faster in order to stay ahead of antibiotic resistance curve.

The discoverer of the first antibiotic (penicillin), Sir Alexander Fleming said in a New York Times article published June 26, 1945, “the microbes are educated to resist penicillin and a host of penicillin-fast organisms is bred out. . . In such cases the thoughtless person playing with penicillin is morally responsible for the death of the man who finally succumbs to infection with the penicillin-resistant organism. I hope this evil can be averted.”

What makes Covid-19 so problematic for doctors is that we have never seen it before and it looks different than a typical viral infection. So, with regard to Covid19, doctors can no longer use their clinical expertise to accurately rule in or out a bacterial pneumonia, even when they know that the primary condition is a virus. Hence everyone gets treated.

Below is a well composed article about antibiotic stewardship.

https://www.healio.com/primary-care/practice-management/news/online/stewardship-in-the-pediatricians-office-its-about-time-to-get-antibiotic-smart

For general information about Covid-19 check out our Covid-Page.

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Dr. Justin Groode | Patient Advocate Alliance

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