Before the 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. Indeed, over 2 years into the COVID-19 pandemic, the dynamics of AMR remain uncertain.

In this talk I will present a structured way for considering how COVID-19 and AMR interact in terms of how antimicrobial usage, infection prevention, and health systems affect the emergence, transmission, and burden of AMR. Some of the COVID-19 related, short-term changes that may lead to reduced AMR prevalence include increased hand hygiene, decreased international travel, and decreased elective hospital procedures. Current data suggest that antibiotic use in the community has decreased since the start of the COVID-19 pandemic. However, high antibiotic exposure in COVID-19 patients and the use of antibiotics more widely as standard healthcare pathways break down will have the opposite effects on AMR prevalence. In pulling together the latest published evidence in this talk I will attempt to bring these complex factors together to improve our preparedness and response to these intersecting public health challenges.

Gwen Knight, London School of Hygiene & Tropical Medicine