The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2;

previously provisionally named 2019 novel coronavirus or 2019-nCoV) disease (COVID-19)

in China at the end of 2019 has caused a large global outbreak and is a major public health
issue (Chih-Cheng Lai ),more so as it is a respiratory tract infection that has the symptom
presentation similar to other respiratory infections, including influenza, bronchitis, and upper
respiratory tract infection ( Hui-An Lin ).

This has posed a challenge for physicians / first line health care providers who haves to
distinguish COVID-19 from other respiratory infections and further evaluate whether to
collect a nasal swab for examination or hospitalizing or isolating a patient((Lin et al., 2020)).
This challenge is not only true for the diagnoses purposes but for treatment options ,literature
denotes that the advent of the coronavirus disease 2019 (COVID-19) pandemic has further
enhanced the problem of antibiotic resistance, as there has been an increase in antibiotic use
despite COVID-19 being a viral infection (Jeremy Hsu)(Hsu, 2020). The current emphasis for
dealing with COVID-19 is on preventive strategies such as social distancing, wearing face
mask and hand washing as there is presently, no treatment that can act specifically against the
SARS-CoV-2 infection(Cristina Stasi)(Stasi et al., 2020).

What is currently observed in literature is that bacterial and fungal co-infection in patients
with COVID-19 is low ,yet, prescribing rates and use of broad-spectrum antimicrobial agents
is high, this combined with the lack of rapid diagnostic and decision support tools to support
the clinical management of COVID-19, increased unnecessary antimicrobial use , that is over
70 % of patients being treated for COVID-19 received broad-spectrum antibiotics despite
only 8 % having a bacterial or fungal co-infection. Hanan Balkhy, assistant director general
for AMR at WHO, raised the same concern of the inappropriate use of antibiotics,
particularly among patients with mild covid-19,” (Timothy M. Rawson) (Jeremy Hsu).In light
of this the World Health Organization discourages the use of antibiotics for mild cases of
covid-19 while recommending antibiotic use for severe covid-19 cases at increased risk of
secondary bacterial infections and death(Jeremy Hsu).

Coronavirus disease 2019 (COVID-19) is currently in the spotlight.Public debates around the
Covid-19 pandemic are currently high profile issues in media and news outlets. Meanwhile,
other longer-term public health issues, such as antimicrobial resistance caused by misuse
and/or overuse of antimicrobials, still exist and the media hype regarding the use of
azithromycin against COVID-19, previous antibiotic prescribing practices, and the
similarities between upper respiratory tract viral infections and COVID-19 may compel some
of the general public to seek antibiotics for treatment is not assisting in arresting the existing
AMR crises. It is therefore important that antimicrobial stewardship programs be inclusive of
the response to COVID-19 and interventions to support the optimal use of antimicrobials
during this time .

Hsu, J. (2020) ‘How covid-19 is accelerating the threat of antimicrobial resistance’, BMJ:
British Medical Journal (Online), 369.

Lin, H.-A. et al. (2020) ‘Clinical impact of monocyte distribution width and neutrophil-to-
lymphocyte ratio for distinguishing COVID-19 and influenza from other upper respiratory
tract infections: A pilot study’, Plos one, 15(11), p. e0241262.

Stasi, C. et al. (2020) ‘Treatment for COVID-19: An overview.’, Eur J Pharmacol, pp.
173644–173644.