COVID-19 impact on AMR: a rapid scoping review, equity analysis and evidence gap map study

Area of Science:

• Public Health
• Infectious Diseases
• Health Systems Research

Background:

• The COVID-19 pandemic potentially altered drivers of antimicrobial resistance (AMR).
• Existing health inequities may have been exacerbated by the pandemic's impact on AMR.
• Understanding these impacts is crucial for future pandemic preparedness.

Purpose of the Study:

• To review how COVID-19 affected antimicrobial use, infection prevention and control (IPC), and health system use.
• To assess the influence of these healthcare system factors on antimicrobial resistance.
• To identify research gaps and equity considerations related to AMR during the pandemic.

Main Methods:

• A rapid scoping review of peer-reviewed literature and WHO COVID-19 Database.
• Searches conducted across MEDLINE, Embase, and Cochrane databases.
• Data extraction focused on AMR emergence, spread, and numbers, with assessment of equity and evidence quality.

Main Results:

• Increased antimicrobial use during COVID-19 correlated with higher AMR in hospitals.
• IPC measures for COVID-19 potentially reduced community-acquired AMR.
• Significant knowledge gaps exist regarding health system use changes and their impact on AMR; few studies addressed equity.

Conclusions:

• COVID-19's impact on AMR is complex and context-dependent.
• More rigorous research is needed on health system and socioeconomic factors influencing AMR during pandemics.
• Integrating antimicrobial stewardship, IPC, and equity-focused surveillance is vital for future pandemic preparedness.