Opinion: the growing use of antibiotics to treat Covid-19 patients will exacerbate the long-term problem of antibiotic resistance

The Covid-19 pandemic has made us all very aware of the power of microorganisms and the impact these tiny organisms can have on every aspect of our lives. What many people may not realise is that we have been facing the silent pandemic of antibiotic resistance for several years. There is concern that some of the steps being taken to manage patients with Covid-19 will exacerbate the problem of antibiotic resistance.

So what is antibiotic resistance? Antibiotics are important drugs that we have been using to treat infection caused by bacteria since the end of the Second World War. Besides being used to treat infection in humans, they are also widely used in veterinary medicine, agriculture and food production.

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From RTÉ Brainstorm, what's causing the increase in antibiotic resistance?

Unfortunately, antibiotic resistant bacteria, often called "superbugs", are appearing and spreading all over the world and some of these superbugs are resistant to almost all of the antibiotics we have. If these superbugs continue to spread, we will no longer be able to treat infection effectively and face the very real threat of going back to a pre-antibiotic era. Without effective antibiotics, we will not be able to safely carry out many of the medical procedures we take for granted today, such as many surgeries and cancer treatments.

While we use large amounts of antibiotics in both human and veterinary medicine everyday, it is not always done correctly. When antibiotics are given to a person or an animal, they affect bacteria throughout the body and not just the bacteria that are causing the infection. The more often we expose bacteria to antibiotics, the more likely they are to change and develop ways to survive and become resistant. Worryingly, these resistant bacteria and indeed a large proportion of the antibiotic itself may then be shed into the environment in human and animal faeces.

There is emerging concern that antibiotics are being used unnecessarily in the management of patients with Covid-19. The majority of respiratory infections, including Covid-19 are caused by viruses. Taking an antibiotic to treat a viral infection will have no impact on the virus causing the infection, but can lead to antibiotic resistance among the bacteria that live in and on our bodies all of the time. Sometimes people that get a cold or flu can get also get a second infection caused by a bacteria, but this is generally only in a small proportion of cases.

There is increasing evidence that antibiotics are being used unnecessarily in the management of patients with Covid-19. Although the actual number of Covid-positive patients with a bacterial infection was very low, reseach has shown that the use of antibiotics was very high. A recent study of several healthcare centres in the US found that 72% of patients received antibiotics even though only only 7% had a bacterial infection.

There is major concern that this unnecessary use of antibiotics will lead to increased antibiotic resistance. The problem of antibiotic resistance has been recognised worldwide as one of the greatest threats to human health. It has been estimated that 10 million people per year will die by 2050 due to infections caused by antibiotic resistant bacteria unless we all take action now. Antibiotic resistance not only impacts on human health but has major implications for our animals, food production systems, environment and economy.

The One Health concept recognises that the health of humans, the health of animals and the health of our environment are interlinked. Governments around the world are taking a One Health approach to combat antibiotic resistance. The World Health Organisation Global Action Plan on Antimicrobial Resistance sets out five key ways to tackle the challenge of antibiotic resistance. The Irish government has adopted this approach and published Ireland's National Action Plan on Antimicrobial Resistance in October 2017.

READ: All you want to know about antibiotics and antibiotic resistance

Some of the actions being taken to tackle Covid-19 align with the actions needed to curb the spread of antibiotic resistance. We are all now keenly aware of the importance of infection prevention and control measures. Practices such as proper and frequent hand hygiene will not only help to stop the spread of Covid-19 but will also help to stop the spread of bacterial infections. A reduction in the number of bacterial infections, could lead to a reduction in the use of antibiotics.

Antibiotics are fantastic drugs that have changed our lives for the better and it is essential we all work together to safeguard antibiotics for future generations. There is a lot we can all do. We need to make sure that the steps we take to manage Covid-19 do not exacerbate the silent pandemic that is antibiotic resistance.

The views expressed here are those of the author and do not represent or reflect the views of RTÉ