AMR challenge in COVID treatment

The world is fighting two pandemics at the same time – COVID19 and the silent pandemic of antimicrobial resistance (AMR), say experts.

Even though the infection caused by SARS-CoV-2 does not require antibiotics per se, it will be a major challenge to treat severe pneumonia, sepsis, and septic shock in COVID-19 patients, as bacterial super-infections may require its use, they say.

Strain on system

Use of a broad spectrum antibiotics might become necessary if infection control practices get compromised due to undue strain on the health-care system resulting from a sudden surge in patient load that may lead to scarcity of ICU beds, as is being witnessed in many parts of the world, says R. Aravind, Head of the Department, Infectious Diseases, Government Medical College Hospital, Thiruvananthapuram.

“The problem at hand is that the AMR pandemic is not exploding in your face, hence it is relegated to the background,’’ he says.

Unscrupulous use of antibiotics will result in AMR that will make it difficult to treat health-care-associated infections due to drug resistant microbes, with the consequence of excess mortality and morbidity, he says.

Restricted use

“Our designated COVID treatment centres are following an antibiotic stewardship programme and the use of antibiotics is optimised as per institutional antibiograms and susceptibility patterns to ensure use of narrow spectrum antibiotics whenever possible. Such restricted use can save COVID-19 patients who are severely sick with co-infections,” he says.

“It is a bad time to talk about AMR, but every one in the Union and State governments is aware of what is happening,” says Abdul Gafur, technical advisor member, National AMR Action Plan.

The State launched the Break the Chain campaign to contain COVID-19 involving the public. And that, perhaps, has been a main success story for the State as far as infection control is concerned.

AMR is a different aspect altogether, but it is important that public involvement is required here too to make it a success.

Nipah was also controlled with public participation, so is COVID-19. Similarly an AMR action plan must involve the public as the primary stakeholders, says Dr. Gafur.