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opinion: antimicrobial resistance should make us think twice about our medicines
3 minute read
unlike other types of drugs, the more antimicrobials are used, the less effective they become.
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this article is a written collaboration by:
brad langford pharmd, dalla lana school of public health, university of toronto, ontario
harpa isfeld-kiely ma, national collaborating centre for infectious diseases, manitoba
andrea kent pharmd, nova scotia health, nova scotia
paul bonnar md, nova scotia health, nova scotia
jason vanstone phd, saskatchewan health authority, saskatchewan
it’s that time of year again. along with the colder weather inevitably comes sniffles, coughs, and sore throats. spreading through daycares, schools and workplaces with the speed of gossip at a family reunion, the untimely symptoms seem to have a knack for hitting right before weekend gatherings and important meetings.
to hasten recovery of cough and cold symptoms, many canadians look to antibiotics. recent public opinion research found that nearly a third of canadians believe that antibiotics ‘are effective against colds and flu’. a doctor’s prescription and you’re on the fast track to recovery, right? at worst it won’t do much harm, right?
a growing number of doctors, pharmacists, and scientists are pushing back against these long-held beliefs.
contrary to popular opinion, most of these upper respiratory infections for which we typically use antibiotics, like sore throat (pharyngitis) and chest cold (bronchitis) are often caused by viruses. a recent study from ontario found that one in four antibiotic prescriptions were for conditions that rarely or never benefit from antibiotics. antibiotics don’t improve these symptoms and what’s often overlooked is they cause side effects, disrupt the microbiome consisting of trillions of protective bacteria, mostly in our gut, and make future infections more difficult to treat.
a growing, but often underestimated, concern is antimicrobial resistance (amr), a term less than a third of canadians know. ‘antimicrobial’ is an umbrella term for drugs that work against microbes, including bacteria, fungi, viruses, and parasites. ‘antibiotics’ specifically applies to antimicrobial drugs used to treat bacteria. unlike other types of drugs, the more antimicrobials are used, the less effective they become. similar to a rebelling teenager, when pressured, microbes develop clever ways to resist the effects of these medicines. like the humans and animals they infect, amr organisms can be highly social and can spread across populations quickly, meaning the use of antibiotics in one person affects how well they work in another.
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amr is quietly gnawing away at the foundations of modern medicine, making a growing number of infections difficult and sometimes impossible to treat. less effective antibiotics for prevention is also a problem, as amr threatens routine procedures that rely on antibiotics like appendectomies, hip replacements and cancer therapy. amr is not coming to canada, it is already here. a report from 2019 estimates that amr kills almost 15 canadians each day. this number more than doubles to 38 per day by 2050 if we don’t take action.
recognizing the need for action, the recently published pan-canadian action plan on amr describes five pillars to address amr:
- leadership across all sectors (human health, animal health, and the environment) to implement change;
- research and innovation to develop and access new antimicrobials;
- surveillance to track the emergence of amr and antibiotic use across humans and animals;
- infection prevention to reduce the spread of amr microbes;
- antimicrobial stewardship to prescribe antibiotics more judiciously.
we can never have too many cooks in the kitchen with amr, everyone has a role to play.
to help bring awareness to amr, world amr awareness week is held each year from november 18th to 24th. drug resistance is a microscopic threat, so a colour campaign entitled #goblueforamr aims to bring visibility to the invisible. landmarks all across canada will illuminate blue to mark the close of this week. to learn how you can participate and find landmarks near you visit: www.antimicrobialawareness.ca.
the threat of amr requires each of us to make small changes to improve our safety and that of our family. next time that pesky winter cough arrives, think twice and ask your doctor, pharmacist, or nurse practitioner about whether the harms of antibiotics might outweigh their benefits. this holiday season, spread joy, not antibiotics. don’t share antibiotics and talk to your pharmacist about disposal of any leftover supply.
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