Antibiotics and Antimicrobial Resistance in the COVID-19 Era.

The dissemination of COVID-19 around the globe was followed by an increased consumption of antibiotics. This is related to the concern for bacterial superinfection in COVID-19 patients. Identification of bacterial pathogens is challenging in low and middle income countries (LMIC) as there are no readily-available cost-effective, clinical or biologic markers that effectively discriminate between bacterial and viral infections. Fortunately, faced with the threat of COVID-19 spread, there has been a growing awareness of the importance of antimicrobial stewardship programs as well as infection prevention and control measures that could help reduce the microbial load and hence circulation of pathogens with reduction in dissemination of antimicrobial resistance. These measures should be improved particularly in developing countries. Studies need to be conducted to evaluate the worldwide evolution of antimicrobial resistance during the COVID-19 pandemic because pathogens do not respect borders. This issue takes on even greater importance in developing countries where scare data on resistance patterns and optimal conditions for infectious pathogen transmission coexist with the suboptimal treatment resources.