Treating coronavirus may raise the antimicrobial resistance in patients

The use of antibiotics in people with coronavirus infection could lead to raised levels of the drugs within rivers or coastal waters which may in turn result in an increase in antimicrobial resistance, as per a UK study. Patients hospitalised due to the novel Covid-19 are being given a combination of medications to prevent the possible secondary bacterial infections, the researchers observed at the University of Plymouth in the United Kingdom.

The study, published in the Antimicrobial Chemotherapy Journal, suggests that their increased use during the pandemic could be placing an additional burden on waste water treatment works.

Scientists distinguished 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, where bacteria become resistant to the action of antibiotics.

They said that, this would be particularly acute in receiving the  waters from waste water treatment works serving large hospitals, or emergency hospitals, where there is a concentration of coronavirus infected  patients.

The result are based on reports that up to 95% of Coronavirus in patients are being prescribed antibiotics as part of their treatment, and raises concerns that such a large-scale drug administration could have wider environmental implications, as stated by  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 Professor of Environmental Chemistry, Sean Comber 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,” Comber said.

The guidance of coronavirus issued by the National Institute for Health and Care Excellence suggests that the patients with coronavirus 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,said  the researchers.

“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,” said  Neil Powell, Consultant Pharmacist at the Royal Cornwall Hospital.

“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,” Powell said.

This research combined patient numbers for United Kingdom 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.

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