November 18, 2021 – The World Health Organization (WHO) has declared that antimicrobial resistance (AMR) is one of the top 10 global public health threats facing humanity. Residents of Newfoundland and Labrador are among the highest users of antimicrobials (including antibiotics) in Canada.
AMR happens when bacteria that cause infections in humans become resistant to the drugs used to inhibit them. World Antimicrobial Awareness Week, November 18-24, 2021, aims to increase awareness of global AMR and to encourage best practices among the public, health workers and policy-makers to avoid the further emergence and spread of drug-resistant bacterial infections (sometimes called “superbugs”). AMR is associated with increased cost of care and poorer patient outcomes.
Dr. Peter Daley is an infectious diseases physician and Co-Chair of the Provincial Antimicrobial Stewardship Committee.
“Prescribers and patients need to work together to slow the creation of antimicrobial resistance in Newfoundland and Labrador. If an antimicrobial is not absolutely necessary, it should not be given,” says Dr. Daley. “Our committee has identified opportunities for significant reduction in antimicrobial use in outpatient care, acute care, and long-term care. Our primary targets are reduction in unnecessary use for viral respiratory tract infections like sore throat and sinus congestion, and positive urine cultures in elderly patients.”
Together with clinicians and health care associations, the Provincial Antimicrobial Stewardship Committee and groups like Quality of Care NL have worked for the last number of years to promote antimicrobial stewardship by sharing best practices and guidelines, providing clinicians with their personal prescribing patterns, and launching a public awareness campaign about the potential harms of overuse.
Despite some modest decreases in antibiotic use since 2016, the rate of oral antibiotic use in the province increased by 6.2% in 2019/20 compared to 2018/19. However, during the first year of the COVID-19 pandemic (1 Apr 2020-31 Mar 2021), the rate of antibiotic prescriptions decreased by 30%, and in the following four months (1 Apr 2021-31 Jul 2021), the rate further decreased by 2.4% compared to the previous 12 months. (Data source: Pharmacy Network)
“The onset of COVID-19 was associated with an immediate large reduction in antibiotic use that continued for 16 months,” says Dr. Pat Parfrey, Clinical Lead of Quality of Care NL. “Masking and social distancing/isolation likely lead to reduced viral infection and fewer presentations to a family physician. Going forward, it is incumbent upon us to use antibiotics wisely, help slow the rate of antimicrobial resistance, and ensure that these life-saving medications will continue to be effective for years to come.”
In cooperation with provincial and regional antimicrobial stewardship committees, and partners in health care, Quality of Care NL will continue efforts to provide information on best practices and feedback to clinicians and educate the public on the threat of antimicrobial resistance.
Quality of Care NL works to improve the quality of care patients receive in our province by facilitating change to ensure that the right treatment, gets to the right patient, at the right time. Quality of Care NL is proud to partner with Choosing Wisely Canada to enable the promotion of established national guidelines and recommendations that cross all disciplines to support the reduction of low-value health care, including unnecessary tests and treatments, particularly where harms outweigh benefits.
The Newfoundland and Labrador Provincial Antimicrobial Stewardship Committee is responsible to reduce antimicrobial use in the province. Reporting to government, the committee uses surveillance, policy and education towards the goal to reduce use by 30-50%.
Quality of Care NL
Dr. Peter Daley
Provincial Antimicrobial Stewardship Committee