Antibiotic usage has risen during the fight against secondary infections in coronavirus patients, raising concerns that it could create a dangerous pathogen.
If the challenge posed by the novel coronavirus pandemic wasn’t bad enough for health authorities, doctors are voicing concerns that the enhanced use of antibiotics to save critically-ill patients could create a drug-resistant superbug.
Even though Covid-19, the disease caused by the new coronavirus, is a viral infection that does not require the use of antibiotics, a large number of people admitted to the intensive care units have to be administered antibacterial medication to treat secondary diseases such as bacterial pneumonia.
A study published in The Lancet medical journal said that 50 percent of coronavirus patients who died in two Chinese hospitals suffered from secondary infections.
In recent years, hospitals around the world have hired specialists to ensure that antibiotics are used only when needed. This can help stop the birth of drug-resistant bacterias such as the Methicillin-resistant Staphylococcus aureus (MRSA).
But when doctors are treating very sick patients and have difficulty in figuring out which pathogen is failing a patient's lungs, they often end up prescribing antibiotics.
Previous influenza outbreaks have shown that other diseases overwhelm an already weakened immune system.
“During the 1918–1920 global influenza pandemic, a large proportion of patients died not from the virus itself but from secondary bacterial pneumonia that spread easily in the crowded hospital wards among the often malnourished and immunocompromised individuals,” experts recently wrote in the Scientific American.
Half of the 300,000 people who had died from the 2009 H1N1 influenza had contracted secondary illnesses.
While it's true that doctors and nurses are taking extra care to stop the spread of pathogens by wearing protective gear, the stress on hospital infrastructure creates problems.
As coronavirus patients poured in, it became obvious that hospitals around the world lacked the required beds and medical gear like N95 masks. But perhaps the biggest concern was the shortage of ventilators, the machines which help severely-infected patients by mechanically moving air in and out of patients’ lungs.
In the face of shortages, many hospitals attached pipes and tubes to the ventilators to help two or more patients use the machines at the same time, raising concerns that it could help a pathogen to spread and grow.
A disaster in making
Studies show that Covid-19 patients are acquiring antibiotic resistance to bacteria such as A baumannii, which causes fatal septic shock
Already, there have been reports of a shortage of a key antibiotic, azithromycin, in the US market. Widespread use of azithromycin in other parts of the world could make it a challenge to treat diseases like the highly drug-resistant typhoid in Pakistan.
Drug-resistant bugs, also known as antimicrobial resistance (AMR), are believed to be the result of widespread and unnecessary use of antibiotics, which has helped dangerous pathogens to evolve.
One of the biggest problems is the lack of investment in the development of new antibiotics. While governments have earmarked trillions to deal with Covid-19, money set aside for drug-resistant bugs is a pittance.
Antibiotic research has almost dried up since the 1980s, when the last novel class of antibiotics were introduced.
Pharmaceutical companies generally spend more than $2 billion on developing a new drug, which has a small market.
Tetraphase, which made the antibiotic eravacycline, was the latest casualty of poor economics. At least three antibiotic makers have shut operations in the past year.
Kenneth E. Thorpe, chairman of the Partnership to Fight Chronic Disease, suggests the introduction of a system of incentives to help antibiotic makers recover the cost of research and development
If all of this were not enough, then experts say that the increased use of disinfectants and antibacterial products these days could help pathogens evolve drug resistance.
“One thing we can all do to help combat the spread of AMR is to use regular — not ‘antibacterial’ — soap,” Lori L Burrows, a professor of biomedical sciences, wrote.