Treating COVID-19 may lead to increased antibiotic resistance, UK study finds

Patients hospitalised due to the novel coronavirus infection are being given a combination of

medications to prevent possible secondary bacterial infections

The use of antibiotics in people with COVID-19 could lead to raised levels of the drugs within

rivers or coastal waters which may in turn result in an increase in antimicrobial resistance,

according to a UK study.

Patients hospitalised due to the novel coronavirus infection are being given a combination of

medications to prevent possible secondary bacterial infections, noted the researchers at the

University of Plymouth in the UK.

The study, published in the Journal of Antimicrobial Chemotherapy, suggests their increased

use during the pandemic could be placing an additional burden on waste water treatment works.

Scientists noted that this could lead to raised levels of antibiotics within rivers or coastal waters

which may in turn result in an increase in antimicrobial resistance (AMR), where bacteria

become resistant to the action of antibiotics.

This would be particularly acute in receiving waters from waste water treatment works serving

large hospitals, or emergency hospitals, where there is a concentration of COVID-19 patients,

they said.

The findings are based on reports that up to 95 per cent of COVID-19 inpatients are being

prescribed antibiotics as part of their treatment, and concerns that such a large-scale drug

administration could have wider environmental implications, according to the researchers.

"COVID-19 has had an impact on almost every aspect of our lives. But this study shows its

legacy could be felt long after the current pandemic has been brought under control,” said Sean

Comber, Professor of Environmental Chemistry in Plymouth.

"From our previous research, we know that significant quantities of commonly prescribed

drugs do pass through treatment works and into our water courses.

"By developing a greater understanding of their effects, we can potentially inform future

decisions on prescribing during pandemics, but also on the location of emergency hospitals and

wider drug and waste management," said Comber.

The COVID-19 guidance issued by the National Institute for Health and Care Excellence

(NICE) suggests patients with COVID-19 should be treated with doxycycline and either

amoxicillin or a combination of other medications if a bacterial infection is suspected, but to

withhold or stop antibiotics if a bacterial infection is unlikely, the researchers said.

"Common with other hospitalised patients in the UK, and other countries, the majority of our

patients with COVID symptoms were prescribed antibiotics because it is very difficult to know

whether a patient presenting with symptoms of COVID has an overlying bacterial infection or

not," Neil Powell, Consultant Pharmacist at the Royal Cornwall Hospital said.

"We did a lot of work to try and identify those patients who were unlikely to have a bacterial

infection complicating their viral COVID infections in an attempt to reduce the amount of

antibiotic exposure to our patients and consequently the environment," said Powell.

This research combined patient numbers for UK emergency hospitals set up temporarily around

the country with waste water treatment work capacity and available river water dilution serving

the emergency hospital and associated town.

https://www.tribuneindia.com/news/health/treating-covid-19-may-lead-to-increasedantibiotic-

resistance-uk-study-finds-131228