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More harm than good

Choosing Wisely NL tackling overuse of antibiotics in the province

By Virginia Middleton and Michelle Osmond

More antibiotics are being used in Newfoundland and Labrador than anywhere else in Canada.

According to the Canadian Antimicrobial Resistance Surveillance System report for 2016, doctors in this province handed out 33 per cent more antibiotics than in Saskatchewan, the second highest user.

More harm that good

Antibiotics have side effects and using them when they are not needed encourages the growth of bacteria that are resistant to the medicine. In fact, more and more drug-resistant bacteria are appearing in Canada every year.

“Antibiotics should be used to treat life-threatening infection caused by bacteria, and should not be used for viral infections.” –Dr. Peter Daley

Choosing Wisely NL, an initiative hosted at Memorial University and developed in collaboration with the Newfoundland and Labrador Medical Association, is reaching out to patients and health-care providers to help them start the conversation about reducing antibiotics use.

“Bacteria resistant to antibiotics spread between people, especially in hospitals and nursing homes, and are extremely difficult to treat,” said Dr. Peter Daley, assistant professor of medicine at Memorial and an infectious diseases physician and medical microbiologist.

“Antibiotics should be used to treat life-threatening infection caused by bacteria, and should not be used for viral infections. This includes not using antibiotics in both adults and children with uncomplicated wheezing, cough, sore throat and runny nose or ear infections.”

Not always necessary

Dr. Natalie Bridger is an assistant professor of pediatrics at Memorial University and is a pediatric infectious diseases specialist. In the following video, she explains why antibiotics are not always necessary when someone is sick.

To help combat the spread of antibiotic-resistant bacteria, Choosing Wisely NL has started a campaign to implement two key recommendations.

First, patients should not use antibiotics for upper respiratory infections that are likely viral, such as colds, influenza-like illnesses or most kinds of sinus infections of less than seven days duration.

The second recommendation is to not use antibiotics to treat bacteria in the bladder in older adults unless specific urinary tract symptoms are present.

Encouraging conversations

Dr. Pat Parfrey, Choosing Wisely NL leader at Memorial, says that members of the program will interact with the public on an ongoing basis to help explain why antibiotics are often unnecessary and can cause harm.

In addition to information sent to primary care providers, Choosing Wisely NL will advertise and spread the word as widely as possible to the public through print messaging, online and radio advertisements and by directing patients back to the Choosing Wisely NL website to learn more about the dangers of antibiotics overuse.

Choosing Wisely NL poster

“We will be working with health-care practitioners to encourage them to prescribe fewer antibiotics, with nursing homes and hospitals to follow best practices so that bacterial resistance does not become a major public health problem,” said Dr. Parfrey.

For more information about Choosing Wisely NL and the latest campaign about antibiotic usage, visit here.


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