Antimicrobial resistance and COVID-19: Intersections and implications

Elife. 2021 Feb 16;10:e64139. doi: 10.7554/eLife.64139.


Before the coronavirus 2019 (COVID-19) pandemic began, antimicrobial resistance (AMR) was among the top priorities for global public health. Already a complex challenge, AMR now needs to be addressed in a changing healthcare landscape. Here, we analyse how changes due to COVID-19 in terms of antimicrobial usage, infection prevention, and health systems affect the emergence, transmission, and burden of AMR. Increased hand hygiene, decreased international travel, and decreased elective hospital procedures may reduce AMR pathogen selection and spread in the short term. However, the opposite effects may be seen if antibiotics are more widely used as standard healthcare pathways break down. Over 6 months into the COVID-19 pandemic, the dynamics of AMR remain uncertain. We call for the AMR community to keep a global perspective while designing finely tuned surveillance and research to continue to improve our preparedness and response to these intersecting public health challenges.

Keywords: COVID-19; antimicrobial resistance; epidemiology; global health.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents* / supply & distribution
  • Anti-Bacterial Agents* / therapeutic use
  • COVID-19* / drug therapy
  • COVID-19* / epidemiology
  • COVID-19* / prevention & control
  • Communicable Disease Control / methods
  • Communicable Disease Control / organization & administration
  • Critical Pathways* / organization & administration
  • Critical Pathways* / trends
  • Drug Resistance, Bacterial / physiology*
  • Global Health / trends*
  • Humans
  • SARS-CoV-2


  • Anti-Bacterial Agents