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New evidence released by the World Health Organization (WHO) on Friday shows that the extensive overuse of antibiotics during the COVID-19 pandemic worldwide, may have exacerbated "silent" spread of antimicrobial resistance (AMR). It added that overall antibiotic use did not improve clinical outcomes for patients with COVID-19. But rather, it might create harm for people without bacterial infection, compared to those not receiving antibiotics. WHO classifies antibiotics as per AWaRe (Access, Watch, Reserve) classification, according to the risk of AMR. Concerningly, the study found that 'Watch' antibiotics with higher resistance potential were most frequently prescribed globally. The highest rate of antibiotic use was seen among patients with severe or critical COVID-19, with a global average of 81%. In mild or moderate cases, there was a considerable variation across regions, with the highest use in the African Region (79%). Antibiotic use ranged from 33% for patients in the Western Pacific Region, to 83% in the Eastern Mediterranean and the African Regions. Between 2020 and 2022, prescriptions decreased over time in Europe and the Americas, while they increased in Africa. Underscoring the urgent need to improve the rational use of antibiotics to minimize unnecessary negative consequences for both patients and populations, WHO said that while only 8% of hospitalised patients with COVID-19 had bacterial co-infections requiring antibiotics, three out of four or some 75% of patients have been treated with antibiotics 'just in case' they help. The findings are based on data from the WHO Global Clinical Platform for COVID-19, a repository of standardized individual-level, anonymized clinical data from patients hospitalised with COVID-19. Data was collected from some 4,50,000 patients admitted to hospitals for COVID-19 in 65 countries over a 3-year period between January 2020 and March 2023. The findings are being presented in a WHO scientific poster shared at the ESCMID Global Congress, taking place in Barcelona, Spain on 27-30 April. "When a patient requires antibiotics, the benefits often outweigh the risks associated with side effects or antibiotic resistance. However, when they are unnecessary, they offer no benefit while posing risks, and their use contributes to the emergence and spread of antimicrobial resistance," Dr. Silvia Bertagnolio, WHO Unit Head for Surveillance, Evidence and Laboratory Strengthening, Division for AMR, said. "These data call for improvements in the rational use of antibiotics to minimise unnecessary negative consequences for patients and populations," he added.