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Pandemic could exacerbate superbug growth – another crisis brewing?

Since the beginning of the pandemic, doctors around the worldself-medication is strictly prohibited. But is it worth saying that only a few listen to them? Often people seek medical help only when the disease is severe, otherwise they take medications, including antibiotics, without a doctor's prescription. Therefore, public health experts are concerned that the misuse and overuse of antibiotics during a pandemic could exacerbate another ongoing crisis - the emergence of pathogens that are resistant to these drugs. As you know, over time, bacteria evolve, and the more people use antibiotics for treatment, the faster this happens, respectively. Antibiotic-resistant microbes currently kill about 750,000 people each year. By 2050, this number could increase to 10 million. However, as a result of the pandemic, the situation may worsen even more. Medicine can be thrown back to the beginning of the last century, when antibiotics did not exist.

Dangerous superbugs are another serious threat to humanity

Why You Shouldn't Take Antibiotics With Coronavirus

In the first months of a pandemic, when patients withCOVID-19 symptoms such as cough, fever, shortness of breath appeared, and at the same time, doctors began to detect pneumonia on chest x-rays, resembling bacterial pneumonia, many patients were prescribed antibiotics. In the US, for example, more than half of patients admitted to hospital between February and July 2020 received at least one antibiotic within the first 48 hours of admission.

Superbugs are resistant to antibiotics

“Many of us have probably prescribed a lotamount of antibiotics. Without a clear understanding of what we were dealing with, we did everything we could at the time, ”says Jacqueline Bork, infectious disease doctor at the University of Maryland Medical Center.

Moreover, many doctors until the last momentprescribe antibiotics to their patients. Only with the advent of the Omicron strain did the situation change, and doctors began to warn against the use of these drugs. But did it even make sense to prescribe antibiotics for coronavirus? The fact is that they destroy only bacteria, but not viruses. SARS-CoV-2 is known to be a virus. From this we can conclude that taking antibiotics is generally pointless. But in fact, not everything is so clear.

It should be borne in mind that against the backdrop of COVID-19,a fungal or bacterial infection occurs. True, it develops in less than 20% of patients. However, according to experts, for people who are hard to tolerate the disease, that is, they are in hospitals with breathing tubes and catheters, antibiotics are necessary. The severe course is often accompanied by bacterial infections that lead to sepsis. In other words, antibiotics should be prescribed by doctors on an individual basis, when it is really necessary.

Antibiotic is often prescribed in the treatment of coronavirus

How Antimicrobial Resistance Develops

Superbugs appeared long before humansbegan to use antibiotics in medicine. In nature, the cause of their occurrence is the “struggle” of bacteria and fungi. Often the latter try to suppress the growth of bacteria or kill them so as not to share resources. For these purposes, they use an antibiotic. I recently reported that the fungus on the skin of hedgehogs began to secrete antibiotics against bacteria several hundred years ago.

Bacteria evolve in the fight for survivaland eventually become resistant to these substances. That is, they begin to produce enzymes that inactivate the antibiotic, removing the drug from bacterial cells. They can also limit the penetration of the antibiotic into the cell.

Sometimes bacteria develop protection against antibiotics,who were not even the original target for the drug. They acquire the appropriate genes from surrounding resistant bacteria through a process called horizontal gene transfer.

Fungi are the cause of naturally occurring antibiotic-resistant bacteria.

However, despite the fact that resistant bacteriaarose without human intervention for a very long time, initially they constituted a small part of the bacterial population in the body. But with the beginning of the use of antibiotics in medicine, their number began to increase. And it's not just about evolution. The drug destroys susceptible bacteria, thereby eliminating competition and allowing resistant microbes to multiply rapidly. An especially large contribution to the development of superbugs is made by improper dosing of antibiotics.

For example, the drug can destroy usefulbacteria in our body and contribute to the emergence of bacteria resistant to many antibiotics. Most superbugs are spread in hospitals. They can also enter the human body through contaminated water, food, direct contact, etc. We recently talked about how the development of superbugs stimulates microplastics.

Recently, more and more people arecarriers of superbugs, and modern antibiotics are becoming less and less effective. This can mean a severe and prolonged course of diseases that until recently people could easily cope with.

In many countries, the use of antibiotics has increased dramatically during the pandemic

How COVID-19 may exacerbate drug-resistant infections

In a recent WHO survey conducted at the end of 2020year, 35 of the 56 countries surveyed increased antibiotic prescribing during the pandemic. In one country, doctors prescribed antibiotics for almost all cases of COVID-19. There are also countries where uncontrolled self-medication with these drugs has been reported.

Typically, physicians prescribehospitalized patients with COVID-19, antibiotics such as azithromycin, doxycycline, fluoroquinolones, cephalosporins, and carbapenems. Outpatients, often with mild symptoms of COVID-19, are also given azithromycin and doxycycline.

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It should be noted that some studiesshowed the effectiveness of azithromycin and doxycycline, as they have antiviral and anti-inflammatory properties. Although a more recent study suggests that these drugs are not effective for COVID-19.

So far, there is no clear evidence that theThe number of bacteria resistant to antibiotics has increased worldwide. But it must be borne in mind that very little attention is being paid to this problem at the moment. The fact is that the global surveillance system for antimicrobial resistance and use, which was launched by WHO in 2015, has suffered due to staff cuts. Therefore, it is possible that the use of antibiotics has already caused damage that will manifest itself soon after the end of the pandemic.