Antibiotic Sales Increased Along With COVID-19 Cases

An analysis of pharmaceutical sales data from 71 countries between 2020 and 2022 reveals the effect of the pandemic on antibiotic use.

Globally, during the first two years of the COVID-19 pandemic, antibiotics were prescribed to 75 percent of COVID-19 patients despite bacterial coinfection rates averaging less than 10 percent.

Unnecessary use of antibiotics potentially aggravates antimicrobial resistance (AMR), which happens as pathogens, such as bacteria, evolve and stop responding to medicines, making infections tough to treat and raising the risk of disease spread, serious illness, and death.

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Antibiotic resistance refers to the adaption of bacteria that allows them to grow even in the presence of antibiotics. The infection by the resistant bacteria are difficult to treat.

‘Antibiotics should not be used in COVID-19 cases unless necessary to prevent antibiotic resistance.’

To understand this relationship in the context of COVID-19 treatment, researchers reviewed associations between COVID-19 cases and immunizations with global antibiotic sales from March 2020 to May 2022.

Researchers sourced monthly data on broad-spectrum antibiotic sales volumes (cephalosporins, penicillins, macrolides, and tetracyclines) in 71 countries from the IQVIA MIDAS database. These data were integrated with Our World in Data's country-month-level COVID-19 case and vaccination data.

Impact of the COVID-19 Outbreak on the Antibiotic Use

To evaluate the relationships between antibiotic sales volumes and COVID-19 cases and vaccines per 1,000 individuals, researchers utilized least squares and fixed-effects panel data regression models, accounting for country-level factors.

This is the first multi-country study to examine clinical and community antibiotic use during the pandemic. The study was published in the journal eClinicalMedicine.

Coronavirus
Coronaviruses infect animals, humans, and birds. Human coronaviruses, such as SARS, MERS, and 2019-nCoV cause respiratory distress and even death. The S protein is the infectious agent of the virus.

The study shows that during 2020–2022, antibiotic sales increased along with increases in COVID-19 cases worldwide, despite decreases in other common infections that would necessitate the use of antibiotics.

Sales of all antibiotics studied had a steep decline in April and May 2020, which was followed by a slow increase to levels that were almost pre-pandemic by May 2022. There were no discernible links found between COVID-19 vaccines and antibiotic sales.

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The pandemic's overall impact on rising aggregate broad-spectrum antibiotic use has been small, perhaps due to fewer non-COVID illnesses resulting from COVID-19 mitigation measures.

Antibiotics should not be used in COVID-19 cases unless necessary, to prevent COVID-19 from turning into another influenza-like illness for which antibiotics are routinely and inappropriately prescribed.

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COVID-19 will likely become endemic and be as virulent as the common cold, so medical guidelines and government policies must be put in place to promote proper antibiotic stewardship.

In a major setback to the global efforts for tackling AMR, billions of excess antibiotic doses may have been prescribed and consumed during the pandemic. The time to act is now.

Source-Eurekalert