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Prescription overload: Preserving antibiotic effectiveness to save lives

By Michelle Osmond

Newfoundland and Labrador leads the way when it comes to overusing antibiotics, and it’s a major public health risk.

Overuse leads directly to the development of resistant bacteria, which spread between people and create a grave risk. According to the British Antimicrobial Resistance Review, at least 700,000 deaths worldwide are due to drug resistance. That number is set to rise.

One prescription per year

In 2016 the national average of antibiotic use was 635 prescriptions per 1,000 people; in Newfoundland and Labrador, that number was 955, according to the Public Health Agency of Canada. Meanwhile, half of the senior residents in this province receive at least one prescription for antibiotics per year.

A team at the Faculty of Medicine is working hard to change those statistics.

For the third year in a row, Quality of Care Newfoundland and Labrador/Choosing Wisely Newfoundland and Labrador (QCNL/CWNL) are working in partnership with Choosing Wisely Canada to promote guidelines and recommendations on the appropriate use of antibiotics.

The group has launched public awareness campaigns about the potential harms of overuse, including a series of easy-to-understand videos, and provided personal ordering data to physicians and nurse practitioners on their antibiotics prescribing patterns. They’ve also developed and distributed tools and resources for clinicians to use to educate their patients.

Improvements to report

The effort seems to be working.

In 2017-18, the total number of antibiotic prescriptions written by family physicians dropped nine per cent compared to the previous year; antibiotic prescriptions per 1,000 people aged 65 years and older enrolled in the provincial drug program dropped 7.6 per cent.

“Antibiotics overuse impacts the future health of us all, not only the health of the person taking the antibiotic,” said Dr. Peter Daley, infectious disease expert in the Faculty of Medicine and co-chair of a provincial antimicrobial stewardship committee.

“We have a social obligation to protect antibiotics from inappropriate and unnecessary use. We are protecting the health of our children and preserving the utility of these drugs for when they are truly needed to save lives.”

“The market potential for new drugs is time-limited because bacterial resistance develops quickly from overuse.” — Dr. Peter Daley

Not only is resistance on the rise, the world is also running out of antibiotics. According to Dr. Daley, pharmaceutical companies are not creating new antibiotics as quickly as they used to.

“The market potential for new drugs is time-limited because bacterial resistance develops quickly from overuse. Our pipeline for new drug development is drying up, making protection of our current drugs even more important.”

The solution: Educating patients on the appropriate use of antibiotics and refusing antibiotics for viral infections.

“Changing antibiotics-prescribing patterns will take time and will depend on consistent effort between the medical community and the public,” said Dr. Pat Parfrey, QCNL/CWNL clinical lead. “Clinicians taking time with patients to provide education and awareness is vital.”

The QCNL/CWNL campaign is running in conjunction with the World Health Organization’s World Antibiotics Awareness Week from Nov. 12-18.

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