Half Of Covid Patients With Secondary Infection Dying
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Overuse of antibiotics and superbugs could be worsening the Covid-19 pandemic in India, according to an ICMR study across 10 hospitals, including two in Mumbai. The study showed that more than half of the Covid-19 patients who get a secondary bacterial or fungal infection die. A secondary infection is one which occurs during or after the treatment of another infection.

The numbers in the study are small: 4% of the 17,000 Covid patients studied had secondary bacterial and fungal infections. But ICMR scientist Kamini Walia, who led the study, said extrapolating these numbers to the overall Covid hospitalisations shows lakhs of people must have had a prolonged hospital stay, needing higher doses of antibiotics to stave off hospitalisation-acquired infections that typically develop after 10 days.

Covid-19 mortality across the world is10%. The sub-group of patients with Covid-19 plus a bacterial or fungal infection, that was part of the ICMR study, had 56.7% deaths.

~ ‘Giving antibiotics for no reason wipes out good bacteria too’

The study also highlighted that many patients needed potent antibiotics as they had superbugs that couldn’t be treated with usual antibiotics. Half of the Covid patients with bacterial infection (52.36%) were given watch category antibiotics as per the World Health Organisation; these are meant to be judiciously used for specific types of infections. A fifth of these patients were given antibiotics categorized as last resort or reserve category.

Drug-resistant variants of Klebsiella pneumonia, acinetobacter baumannii and pseudomonas aeruginosa were among the most common bacterial infections. Overuse of antibiotics and anti-fungals could have contributed to a surge in rare infections such as black fungal or mucormycosis.

17% of the Covid-19 patients had secondary infections, 73% were given antibiotics. Antibiotics are needed for such a Covid patient, but what is worrying is excess antibiotics that could cause 'pressure' on the pathogens who will end up becoming drug-resistant. The longer a patient stays in hospital, higher is the chance of him/her requiring ICU or ventilator.

The pattern of antibiotic use at home by Covid patients too could have long-term repercussions; after the rampant use of azithromycin, it remains to be seen if it will be effective against typhoid in the future, said Dr Walia.