How can lessons from the COVID-19 pandemic enhance antimicrobial resistance surveillance and stewardship?

• Published in: The Lancet infectious diseases 2023-08, Vol.23 (8), p.e301-e309
• Main Authors: Walia, Kamini, Mendelson, Marc, Kang, Gagandeep, Venkatasubramanian, Ramasubramanian, Sinha, Rina, Vijay, Sonam, Veeraraghavan, Balaji, Basnyat, Buddha, Rodrigues, Camilla, Bansal, Nitin, Ray, Pallab, Mathur, Purva, Gopalakrishnan, Ram, Ohri, Vinod C
• Format: Article
• Language: English
• Subjects: Adult; Anti-Bacterial Agents - therapeutic use; Antimicrobial agents; Antimicrobial resistance; Community involvement; Community participation; COVID-19; Drug Resistance, Bacterial; Fragility; Health risks; Humans; Immunization; Income; Infectious diseases; Laboratories; Low income groups; Pandemics; Pandemics - prevention & control; Public health; Regeneration; Risk communication; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Vaccination
• ISSN: 1473-3099; 1474-4457
• DOI: 10.1016/S1473-3099(23)00124-X

COVID-19 demanded urgent and immediate global attention, during which other public health crises such as antimicrobial resistance (AMR) increased silently, undermining patient safety and the life-saving ability of several antimicrobials. In 2019, WHO declared AMR a top ten global public health threat facing humanity, with misuse and overuse of antimicrobials as the main drivers in the development of antimicrobial-resistant pathogens. AMR is steadily on the rise, especially in low-income and middle-income countries across south Asia, South America, and Africa. Extraordinary circumstances often demand an extraordinary response as did the COVID-19 pandemic, underscoring the fragility of health systems across the world and forcing governments and global agencies to think creatively. The key strategies that helped to contain the increasing SARS-CoV-2 infections included a focus on centralised governance with localised implementation, evidence-based risk communication and community engagement, use of technological methods for tracking and accountability, extensive expansion of access to diagnostics, and a global adult vaccination programme. The extensive and indiscriminate use of antimicrobials to treat patients, particularly in the early phase of the pandemic, have adversely affected AMR stewardship practices. However, there were important lessons learnt during the pandemic, which can be leveraged to strengthen surveillance and stewardship, and revitalise efforts to address the AMR crisis.