WHO updates recommendations on use of antibiotics for Covid-19 patients

The WHO has recommended against the use of antibiotics even in patients with severe Covid when a concurrent bacterial infection is not suspected.

The global health body has released updated recommendations for the clinical management of people with Covid which, it said, are based on evidence generated from recent meta-analysis of outcomes of patients treated with antibiotics for Covid.

"For patients with non-severe COVID-19 and a low clinical suspicion of a concurrent bacterial infection, we recommend no empirical antibiotics. For patients with severe COVID-19 and a low clinical suspicion of a concurrent bacterial infection, we suggest no empirical antibiotics," the WHO said.

The WHO said that as COVID-19 epidemiology and severity have changed, and as emergency measures have subsided, the evidence behind a number of recommendations has changed.

In parallel, evolution of health systems and the global environment have meant that the recommendations are implemented in a very different context in 2024 compared to 2020.

These guidelines have evolved from the first version in 2020 in line with new information and changing circumstances of the pandemic, the WHO said.

"Notable changes to COVID-19 disease over this time have been overall reduced infection rates and reduced disease severity. Emergency measures which were imposed have also been removed, and care for patients with COVID-19 has become more integrated with usual healthcare systems.

"This different environment has prompted a review of the scope and content of all existing guidance. In order to maintain a clear focus and relevance, we have removed recommendations which would be considered general medical principles, and those which are no longer specific to the management of COVID-19," the WHO said.

The new recommendations on use of antibiotics were prompted by the publication of data from a systematic review and meta-analysis, and the pressing need to address antimicrobial resistance.

The WHO said that the updated guidelines are for people directly or indirectly involved in the health care of patients with COVID-19 and post COVID-19 condition. This includes clinicians, allied health care workers, facility managers and hospital administrators.

The SARS-CoV-2 continues to infect several thousands of people daily leading to preventable morbidity and mortality across the world, the WHO said.

The roll-out of vaccines and treatment for COVID-19, and increasing population immunity from infection has substantially reduced hospitalization, severity of disease, and mortality.

"However, the virus continues to evolve in terms of infectivity, immune escape, and disease severity. This guideline robustly and transparently addresses the changing landscape and evidence availability, and the continual development of treatment and management strategies for COVID-19," the WHO stated.