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A possible risk for the evolution of antimicrobial resistance from COVID-19 drug practices

A possible risk for the evolution of antimicrobial resistance from COVID-19 drug practices

Microbial drug resistance is one of the major problems in modern medicine. As COVID-19 therapy is increasingly dependent on pharmacological treatment, the risk of quickening the evolution and spread of antimicrobial resistance increases.

This disturbing comment co-authored by dr hab. inż. Paweł Łabaj, appeared recently in the Lancet Microbe. A study conducted in a senior hospital setting showed that trends in microbial colonisation over a long period of time are alarming. The study also highlighted the diversity of antimicrobial resistance gene pools in hospitals, which may contribute to the emergence and transmission of new antibiotic resistance patterns.

Admissions and discharges of patients from specialty hospitals have increased dramatically over the past year due to the COVID-19 pandemic, and many hospitals have expanded excessively. The increase in hospital admissions due to the COVID-19 pandemic, combined with weakened patient immunity, has resulted in a significant increase in the risk of co-infection. Inadequate understanding of this phenomenon and co-morbidities in COVID-19 has contributed to rapid changes in patient treatment protocols, including the use of multiple drugs worldwide (Figure). The use of antiparasitic, antiviral, antibacterial and anti-inflammatory drugs to prevent secondary infections in COVID-19 patients during a prolonged pandemic will inevitably lead to future complications, including increased antimicrobial resistance. This is particularly relevant in view of the successive emergence of mutations that increase the effectiveness of the SARS-CoV-2 virus, which may be responsible for recurrent COVID-19 outbreaks.

 

Figure Use of multiple COVID-19 drugs in practice. Timeline of first appearance of major antiparasite, antiviral, antibacterial, and anti-inflammatory drugs for the treatment of COVID-19 in preprints, in a peer-reviewed article, as a Google search trend, as a worldwide Twitter trend, and the first time mentioned by WHO in situation reports. 

The situation has been worsened by the fast publication of scientific articles without thorough peer review and their subsequent recommendation by WHO and other centres for disease control and prevention worldwide. Imperfect drug absorption in COVID-19 patients, which can lead to rapid evolution of multidrug resistance, can be highlighted as another threat.

The reserach was carried out by the MetaSUB International Consortium.