Antibiotic stewardship in COVID19 pandemic

Abstract

It is estimated that worldwide approximately 700000 deaths occur annually due to antibiotic resistance. The UN Interagency Coordination Group on Antimicrobial Resistance has warned that antibiotic resistance could cause 10 million deaths each year by 2050.History has witnessed a deadly pandemic of 1918, that affected 1/3^rd of world population and resulted in nearly 50 million deaths, and most of the deaths were attributed to secondary bacterial infections based on post mortem studies^1,2. During influenza pandemic in 2009, bacterial infections were reported in patients of H1N1 to the extent of 30% in some studies³. Likewise, possibility of co-infection or secondary bacterial infection in patients of COVID19 remains a driving stimulus for use of antibiotics; thus, rising concern of antibiotic resistance. Antibiotics are used in severe COVID19 illness worldwide with many guidelines advocating their use⁴.However, with nearly two years of journey into current pandemic, how much are we justified  with the routine use of antibiotics in treatment of COVID19 illness?