Americas report surge in drug-resistant infections due to misuse of antimicrobials during pandemic

Misuse of antimicrobial drugs

Ivermectin and Chloroquine among drugs proven ineffective against COVID-19. PAHO calls for responsible use of antimicrobials to prevent further spread of resistance.

Washington D.C., November 17, 2021 (PAHO) – Countries in the Americas are reporting surges in drug-resistant infections that are likely due to the unprecedented misuse of antimicrobial drugs in the treatment of COVID-19, warned the Pan American Health Organization (PAHO) Director, Dr. Carissa F. Etienne, during a media briefing today.

“Throughout this pandemic, we have taken the power of antimicrobials for granted,” the Director said on the eve of World Antimicrobial Awareness Week. “And while it may be months or even years until we see the full impact of their misuse and overuse, we cannot afford to wait to take action.”

Data shows that more than 90% of hospitalized COVID patients in the Americas were given an antimicrobial, while only 7% required these drugs to treat a secondary infection. Drugs such as Ivermectin, Azithromycin and Chloroquine were also widely used, despite strong evidence that they have no benefit against COVID-19.

With many ICUs in the region operating at 2 to 3 times their capacity during the pandemic, there has also been a rise in invasive procedures such as intubation and ventilation. This, combined with issues such as overcrowding and the limited availability of personal protective equipment (PPE), including gloves and gowns, also contributed to hospital infections spreading more quickly.

“Antimicrobials are crucial life-saving drugs, but they must be used responsibly since bacteria can develop resistance and render these drugs ineffective over time,” said the PAHO Director.

Several countries, including Argentina, Uruguay, Ecuador, Guatemala, and Paraguay have reported increases in drug-resistant infections. A recent PAHO Epidemiological Alert also shows a spike in the emergence of bacteria resistant to antimicrobials in the region.

Health professionals everywhere should practice responsible use of antimicrobials and prescribe antimicrobials only when needed. Misusing these drugs is harmful to patients and also to public health.”

Dr. Carissa F. Etienne


The PAHO Director also called for better surveillance, stewardship, and drugs to preserve the power of antimicrobials.

While many countries have expanded their surveillance systems during the pandemic, these networks must now be leveraged to track antimicrobial resistance. Countries should also develop evidence-based treatment guidelines for clinicians and must invest in new and better antimicrobial drugs.

“We need all countries to work together now to control the rise in antimicrobial resistance so we can continue to rely on these drugs to treat diseases and prevent an unprecedented crisis,” she said.

Turning to the COVID-19 situation in the region, Dr. Etienne said that in the past week there has been a 5% overall decrease in new cases in the Americas, and a leveling off of new infections in the most populous countries such as the US, Brazil, and Colombia, as well as in countries across Central and South America, with the exception of Bolivia, Uruguay and Chile.

In North America, cases continue to decline in Canada.

In the Caribbean, cases continue to rise in the Dominican Republic and Barbados. The Cayman Islands and Trinidad and Tobago are also experiencing high levels of infections.

The PAHO Director warned that while half of people in Latin America and the Caribbean are now fully vaccinated, “the COVID pandemic is still very active in our region."

As the holiday season draws near, “it’s up to all of us to keep each other safe by getting vaccinated and following the public health measures that have proven effective against this virus,” she urged.