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COVID-19 pandemic reverses progress in fight against antibiotic resistance in U.S.

By Tamas Mondovics


To many, the COVID-19 pandemic is over. To some people, it never happened. Yet, to those that had to endure the pain and sorrow that resulted from the spread of the disease, taking precautions is still a priority, and for a good reason.

According to a recent release from the Centers for Disease Control and Prevention (CDC), the COVID-19 pandemic pushed back years of progress made in combating antimicrobial resistance (AR) in the United States.

“This setback can and must be temporary,” said Michael Craig, MPP, Director of CDC’s Antibiotic Resistance Coordination & Strategy Unit.

Craig emphasized that
the COVID-19 pandemic has “unmistakably shown
us that antimicrobial resistance will not stop if we
let down our guard; there is no time to waste. The best way to avert a pandemic caused by an antimicrobial-resistant pathogen is to identify gaps and invest in prevention to keep our nation safe.”

The CDC analyzed the state of antimicrobial resistance in the U.S. The data show an alarming increase
in resistant infections starting during hospitalization, growing an overall 15 percent from 2019 to 2020 among several pathogens. Antifungal-resistant threats also rose in 2020, in some cases by 60 percent in hospitals.

By comparison, in a 2019 report, significant national reductions in hospitals were celebrated, where antimicrobial-resistant infections fell by 27 percent 2012 to 2017. COVID-19 changed all that.

Clostridioides difficile or  C. diff, a germ (bacterium) that causes severe diarrhea and colitis, is the only healthcare-associated pathogen to improve in 2020, likely driven partly by changes in healthcare-seeking behavior.

CDC data shows significant surges in antibiotic use in U.S. hospitals and difficulty in following infection prevention and control guidance.

“During the pandemic, hospitals experienced personal protective equipment supply challenges, staffing shortages, and longer
patient stays. Hospitals also treated sicker patients who required more frequent and longer use of medical devices like catheters and ventilators. The impact of the pandemic likely resulted in an increase of healthcare-associated, antimicrobial-resistant infections,” the release stated.

During the first year of the pandemic, more than 29,400 people died from antimicrobial-resistant (AR) infections commonly associated with healthcare. Of these, nearly 40 percent got the infection while they were in the hospital. The total national burden of deaths from AR may be much higher.

According to the CDC, from March 2020 to October 2020, almost 80 percent of patients hospitalized with COVID-19 received an antibiotic. The high level of prescribing can create a pathway for resistance to develop and spread.

“We need to emphasize and expand the implementation of the effective prevention strategies already in CDC’s toolbox to all healthcare facilities,” said Denise Cardo, MD, Director of CDC’s Division of Healthcare Quality Promotion.

The CDC is promising to remain at the forefront of combating antimicrobial resistance. “The fight will now take on a renewed fervor in prevention-focused public health actions to keep the nation safe.”