Antiviral resistance (AVR) can’t be forgotten. Particularly in immunocompromised patient

populations – it’s mainly driven by viral replication and prolonged drug exposure.¹
 

WHO (World Health Organization) have not yet released a list of priority viral pathogens to

match the equivalent records for bacterial and fungal pathogens, but we must take AVR

seriously. We are now in a situation where resistance has developed to most antivirals.¹

COVID-19 AND THE RESISTANCE
 

While the relentless rise in multi-drug resistant infections poses a significant threat to global

health, the coronavirus disease (COVID-19) pandemic has been one of the most profound

health challenges of our time. Pandemic-related issues may have caused us to lose progress in combatting wider antimicrobial resistance (AMR), and could play a part in the development of resistance to approved COVID-19 medications.^2–5
 

Due to difficulties distinguishing COVID-19-related pneumonia from other bacterial, fungal, or

viral causes, broad-spectrum antimicrobials are frequently inappropriately prescribed to

patients hospitalized with COVID-19. This potentially acts as a catalyst for the development of overall AMR.⁴
 

While equivalent WHO guidance on viral priority pathogens does not yet exist, the underlying

principles of antimicrobial stewardship still apply. Any time antimicrobials are used, they can

contribute to resistance.² But when antimicrobials are needed, we must use them early (at the right time) and at the right dose, to optimize patient outcomes. It’s more important than ever to use them judiciously.