COVID-19: don’t neglect antimicrobial stewardship principles!

The SARS-CoV-2 pandemic is currently dominating every aspect of health care across the globe putting other longer-term public health issues, including the steady rise of antimicrobial resistance, in the shadow. Yet, there will be a time after COVID-19 and we should not lose sight of problems that will persist and may potentially be exacerbated by this pandemic.

An important proportion of patients with COVID-19 present with fever and cough. Those requiring hospitalization because of dyspnea usually present bilateral radiologic infiltrates. Despite the viral origin of COVID-19, a standard reflex by physicians is to start treatment with antibiotics since cough, fever and radiologic infiltrates are hallmarks of bacterial community-acquired pneumonia which requires antibiotic treatment. The anxiety and uncertainty surrounding the pandemic and the absence of antiviral treatments with proven efficacy are probably other contributors to the widespread and excessive prescription of antibiotics.