Volume 5, Apr - Jun 2022
Editorial Note:
Author’s Affiliation:
1- Department of Paediatric Medicine, Lahore General Hospital, Pakistan.
Received on: 30-Jun-2022
Accepted for Publication: 25-Jun-2022
Article No: 22630YTc024618
PDF - Full Text

During pandemic of coronavirus disease 2019 (COVID-19), the world is facing another even greater and silent pandemic, which is antimicrobial resistance (AMR). AMR is prematurely killing thousands of people worldwide.1 The coronavirus disease 2019 (COVID-19) pandemic has had a substantial impact on health systems globally, affecting the management of other health threats, such as antimicrobial resistance (AMR). The World Health Organization (WHO) has declared the AMR as one of the top ten global health threats.2 AMR increases the healthcare costs, hampers the control of infectious diseases and has the potential to threaten health security, and weaken trade and economies.3


During COVID-19 pandemic, overuse of antibiotics was observed. The apparent rationale for prescribing antibiotics in these patients might be due to the previous experience with increased mortality in patients due to bacterial super-infection in influenza, where many studies demonstrated initial co-infection or secondary bacterial pneumonia in hospitalized

patients.4 In this context, effort for better care of COVID-19 patients with best available guidelines has inadvertently declined the adherence to stewardship programs.5


The global threat of AMR will persist beyond the COVID-19 crisis.  Experts have highlighted the link between COVID-19 and AMR, indicating that certain changes, such as increased antimicrobial use, could drive an increase in AMR; while other activities, such as improved infection prevention and control (IPC), might reduce AMR rates.6 The targeted, rational treatment of secondary bacterial infections should be an integral part of pandemic planning. There are few challenges. In developing countries like Pakistan, there is lack of resources for AMR surveillance programs. There is increase in pre-emptive antibiotic prescribing to prevent secondary bacterial infections. Also are the delays in AMR legislation. However, there are few opportunities as well. We may integrate AMR risk into investment practices and prioritize antimicrobial stewardship program. We may work on development of rapid diagnostics. There is need to develop political will on AMR, and make collaborative public information campaigns to combat the threat of this silent pandemic.



  1. Founou RC, Blocker AJ, Noubom M, Tsayem C, Dongen MV, Founou LL. The COVID-19 pandemic: a threat to antimicrobial resistance containment. Future Sci 2021;7(8): doi: https://doi.org/10.2144/fsoa-2021-0012
  2. World Health Organization. Global Action Plan on Antimicrobial Resistance. Online 2016 [cited June 05, 2022]. https://www.who.int/antimicrobialresistance/global-action-plan/en/
  3. Lai CC, Shih TP, Ko WC, Tang HJ, Hsueh PR. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): the epidemic and the challenges. Int. J. Antimicrob Agents 2020;55(3): 105924.
  4. Klein EY, Monteforte B, Gupta A, Jiang W, May L, Hsieh Y, et al. The frequency of influenza and bacterial coinfection: a systematic review and meta-analysis. Influenza Other Respir Viruses 2016;10:394–403. http://dx.doi.org/10.1111/irv.12398.
  5. Ginsburg AS, Klugman KP. COVID-19 pneumonia and the appropriate use of antibiotics. Lancet Glob Health 2020;8:e1453–4. http://dx.doi.org/10.1016/S2214-109X(20)30444-7.
  6. Getahun H, Smith I, Trivedi K. Tackling antimicrobial resistance in the COVID-19 pandemic. Bull World Health Organ 2020;98:442-442A.
Disclaimer: The Views and opinions expressed in the articles are of the authors and not of the journal.
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