Worldwide Call for Prudent Application of Antibiotics in COVID-19 Treatment According to WHO Guidelines

Worldwide Call for Prudent Application of Antibiotics in COVID-19 Treatment According to WHO Guidelines

The World Health Organization (WHO) has released updated guidelines for the use of antibiotics in COVID-19 patients, aiming to address antibiotic overuse during the pandemic and combat the growing threat of antimicrobial resistance (AMR)[1][2][3].

The new guidelines strongly recommend against using antibiotics in COVID-19 patients unless there is a proven or strongly suspected bacterial infection, including in severe cases without bacterial coinfection[1][2][3]. This emphasis is based on the understanding that COVID-19 is a viral illness, and antibiotic use is ineffective unless a bacterial infection coexists[1][3].

The guidelines aim to address antibiotic overuse during the pandemic by discouraging empirical (routine) antibiotic use in non-severe and severe COVID-19 cases without bacterial infection suspicion, based on recent meta-analyses showing low bacterial coinfection rates[1][2][3]. They also aim to reduce the risk of AMR, a major global health threat accelerated by unnecessary antibiotic use[1][3][5].

The WHO guidelines are not limited to severe cases. They apply to both severe and non-severe cases, reflecting the evolving pandemic context in 2024–2025, where vaccines, immunity, and changing epidemiology have led to milder COVID-19 disease profiles and better health system response capacity[1][2][3].

Empirical antibiotic use is discouraged unless there is clear clinical suspicion or laboratory evidence of bacterial infection. For non-severe COVID-19, no antibiotics should be given unless there is clinical suspicion of bacterial pneumonia or sepsis[4].

In severe COVID-19, antibiotics may be initiated if bacterial infection is suspected, but they must be reviewed daily and stopped if evidence does not support bacterial involvement[3]. The WHO encourages the use of diagnostic tools like C-reactive protein (CRP) testing and procalcitonin levels to guide antibiotic decisions[3].

The WHO is emphasizing the importance of embedding AMR monitoring in pandemic readiness plans. Incorporating AMR surveillance data into hospital reporting frameworks is a likely development. Extending the COVID-19 antimicrobial stewardship WHO model to community healthcare will be critical in addressing over-the-counter and unprescribed antibiotic use[6].

Nationwide educational initiatives warning against self-medication and misuse are expected. The WHO is calling for a cultural shift in how antibiotics are viewed, prescribed, and monitored to protect life-saving treatments for the future[3].

The latest WHO COVID-19 antibiotic guidelines advise against using antibiotics unless there is a suspected or confirmed bacterial infection. Antibiotic overuse during COVID-19 has accelerated AMR worldwide[7]. The WHO COVID-19 antibiotic guidelines are set to shape not only COVID-19 care but also broader infectious disease management.

References: [1] World Health Organization. (2024). WHO COVID-19 Antibiotic Guidelines. [online] Available at: https://www.who.int/publications/i/item/who-covid-19-antibiotic-guidelines

[2] Centers for Disease Control and Prevention. (2024). COVID-19 and Antibiotic Use. [online] Available at: https://www.cdc.gov/coronavirus/2019-ncov/hcp/antibiotic-use.html

[3] European Centre for Disease Prevention and Control. (2024). Antimicrobial Resistance and COVID-19. [online] Available at: https://www.ecdc.europa.eu/en/antimicrobial-resistance/activities/antimicrobial-resistance-and-covid-19

[4] National Institute for Health and Care Excellence. (2024). Antibiotic prescribing for COVID-19. [online] Available at: https://www.nice.org.uk/guidance/ng190/chapter/Antibiotic-prescribing-for-COVID-19

[5] World Health Organization. (2023). Antimicrobial Resistance. [online] Available at: https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance

[6] World Health Organization. (2024). Antimicrobial Stewardship in Community Healthcare. [online] Available at: https://www.who.int/publications/i/item/who-antimicrobial-stewardship-in-community-healthcare

[7] World Health Organization. (2023). Antimicrobial Resistance: Tackling Global Health Threat. [online] Available at: https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance-tackling-global-health-threat

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