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Friday, 18 November 2011

Antibiotic Awareness Week - are you using your antibiotics wisely?

It is National Antimicrobial Awareness Week.  Somewhat aligning with the start of the cold and influenza season where inappropriate antibiotic prescribing hits its peak.   This site has addressed the issue of superbugs and antimicrobial use on multiple occasions July 8, 12, August 29, 31, Sept 1, 2, 19 and 26.  But really, who is counting?   Its just one of those public health issues that needs a home, needs champions and needs to be addressed.  
Antibiotic stewardship is integral to reducing dissemination of antibiotic resistant organisms (ARO), prolonging the effective life expectancy of newer antibiotics, and most importantly reserving antibiotics for treating severe illness and saving lives.  There are not many new antibiotic opportunities coming down the pipeline to maintain protection from infectious disease. 
The Canadian Antimicrobial Resistance Alliance CAR-A has become the default organization for providing leadership in the country.  Notable about CAR-A is the focus on institutions and specialists, and the lack of public health involvement.  There are some good statistics, but minimal trending information on the antimicrobial surveillance tab.   The ability to compare geographic areas exists, although the format is not user friendly to identify where substantive variance in practices is in place, or variance in policies like formulary restrictions.
The Canadian track record is passable and better than some countries, but certainly not in the same league as Denmark or other Scandinavian countries where policy limitations are designed to prolong the use of antibiotics.
And where is PHAC, at least they have started to take a leadership role, but what are the objectives and the deliverables?  The focus of work is based on the group that has historically looked at animal based antimicrobial use, and while an issue it is not the main ARO problem.  Humans prescribing and using antibiotics are the primary problem and we know less about that than we do about animal husbandry management with antibiotics.
Add to this are efforts by other health care professionals to increase access to prescribing antibiotics, rather than reducing access by existing health care professionals to this vital service only when needed.   
Next time your health care professional offers you an antibiotic, at least ask if there is another alternative to be considered first. 

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