Worrying News: AMR Rates Rising Since Pandemic Began

Antimicrobial resistance (AMR) is in the news again – and it’s not good. The Centers for Disease Control and Prevention (CDC) issued a special report, detailing that AMR rates rose in 2020, primarily due to the COVID-19 pandemic. This is worrisome, given the work that has gone into lowering AMR rates over the past several years.

Antimicrobial resistance is the ability for germs to resist antibiotic, antiviral, and antifungal medications. It has been named one of the top 10 global public health threats facing the world by the World Health Organization (WHO).

Why the Increase in AMR Rates?

According to the report, the problems started with an increase in antibiotic prescriptions. Many people with respiratory complications related to COVID-19 received antibiotics whether it was obvious they needed them or not. Almost 80% of patients admitted to the hospital with the virus got antibiotics.

Not only were more patients getting antibiotics, but they were also taking them for longer periods. The average time of antibiotic use before the pandemic was about 3.5 days. During the pandemic, this rose to 3.8 days overall. It was even longer – 5.7 days – if patients tested positive for SARS-CoV-2, the virus that causes COVID-19.

Several Possible Causes for Higher AMR Rates

A study reported in April found that all patients hospitalized since the start of the pandemic had higher AMR rates than those hospitalized before 2020, regardless of COVID-19 status. There isn’t one reason alone for the rise in drug-resistant infections. Causes include:

• Increased antibiotic use
• Less attention on infection prevention in healthcare facilities
• Increased numbers of patients susceptible to healthcare-acquired infections (HAIs)

It’s not unusual for a doctor to prescribe antibiotics to a patient based on symproms before doing a blood culture. This is a test that determines if there is an infection and what type. Pre-pandemic, over 17% of patients who weren’t cultured or had negative tests (no infection) received antibiotics for more than 72 hours. This rose to over 19% among all patients in 2020 and more than doubled to just over 41% when counting only patients with the virus.

The higher number of vulnerable patients who needed invasive devices and interventions like ventilators and urinary catheters also led to more infections. And infection prevention protocols in healthcare facilities often took a backseat due to staff and supply shortages.

Community Rates Dropped

Interestingly, as much as AMR cases rose in healthcare facilities, the number of cases in the community dropped. The CDC credits less spread of respiratory illnesses that could lead to pneumonia and other infections, due to:

• Wearing masks
• Social distancing
• Avoiding crowded spaces
• Fewer people seeking care in clinics and doctors’ offices, limiting virus exposure even more

“These new data highlight the importance of closely monitoring the impact of COVID-19 on antimicrobial resistance rates,” said Karri Bauer, PharmD, from Merck Sharp & Dohme, in a press release. “It is particularly worrying that antibiotic resistance has been rising during the pandemic in both SARS-CoV-2 positive and negative patients. Hospital-acquired infections are a major concern, with antimicrobial resistance rates significantly higher during the pandemic than before.” Bauer conducted the study with Vikas Gupta, PharmD, director of Medical Affairs at Becton, Dickinson and Company.

You Can Help Reduce AMR Rates

Everyone has a role to play in stopping the rise of more “superbugs,” microbes that are antimicrobial resistant. Bacteria are the most common organisms that develop drug resistance, mainly driven by antibiotic overuse.

The first step is to follow infection prevention practices on your own. Wash your hands frequently and thoroughly, avoid sick people, and get recommended vaccines. If you become ill anyway, you can still help reduce AMR rates.

Antibiotics kill or stop bacteria from reproducing or spreading. They do not have any effect on viral infections. If a viral infection goes away while you take antibiotics, the virus ran its course – it’s not because of the drugs. Finally, don’t insist on an antibiotic if your doctor or nurse practitioner tells you that you don’t need one.

If you have an infection, take your medications as prescribed for the whole period, even if you feel better. Speak with your doctor if you experience side effects and you need to stop taking the medication. Don’t just stop on your own.

Infections caused by resistant germs are much more difficult to treat and there is fear that some may eventually not be treatable at all. These infections can quickly lead to sepsis, a life-threatening response to any type of infection. As more infections become more difficult to treat, sepsis cases will rise.

You can learn more about Sepsis Alliance’s efforts to reduce the incidence of superbugs at Power The AMRevolution, a national initiative to educate people about the risks of AMR and steps people can take to end superbugs.