Coinfections and antimicrobial resistance;Discovering positive and negative implications during COVID-19 pandemic

Background: The clinical spectrum of SARSCoV-2 infection that caused the epidemic appears tobe wide since asymptomatic infection to severe viralpneumonia with respiratory failure and even death.Despite its viral nature antibiotics are prescribed frequently to patients, largely due to suspected bacterialco-infections. Among the responsible factors of antimicrobial resistance: Overuse of Antibiotics,Underuse, and Misuse of Antimicrobials, PoorInfection Control Practices, International Travel,Poverty, etc. Understanding patterns and predictorsof antibiotic prescribing helps to identify opportunities for interventions, target antibiotic stewardshipstrategies to improve antibiotic use.Objective: To determine the impact and influence of the SARS-CoV-2 and its co-infections onthe current antimicrobial resistance situation.Methods: We conducted a review using PubMed,the search yielded 82 citations where 66 failed tomeet the inclusion criteria and 16 were includedin this review.Results: Co-infection rates for SARS-COV-2have been estimated between 6.1% and 8.0%,72% were treated with antibiotics, of whom 15%received anti-fungal treatment.Discussion: Experts in the topic argue thatCOVID-19 will result in an increase in antimicrobial resistance rates (AMR). Patientsadmitted during the pandemic are at risk of beingtreated with broad spectrum antibiotics despitethe low prevalence of coinfection, being exposedto procedures that are known risk factors forAMR development. While the counterpart fromother experts argue that COVID-19 will not leadto increased AMR rates because of the decreasedtransmission factors in healthcare and community settings, international travel and all the others antimicrobial resistance factors.Conclusion: The impact of COVID-19 on antimicrobial resistance rates remains to be determined and it is likely to be heterogeneous due tovariation in health care practices. Antibiotic prescribing should be regulated according to nationalguidelines and used only when needed. Theglobal impact is yet unknown and will becomeclear in time as data become available.