Ontario's Doctors: Antibiotic Resistance Poses Major Threat to Public Health

TORONTO, March 20, 2013 /CNW/ - One of the most fundamental and life-saving tools in medicine is endangered. Ontario's doctors are calling on government to address the growing crisis of antibiotic resistance while there is still time.

According to a new report by the Ontario Medical Association, infections with antibiotic-resistant bacteria are becoming more frequent and difficult to treat, resulting in serious illness and even death. Ontario's doctors warn that the over-use of these crucial medicines weakens their ability to save human lives; we call on federal and provincial governments to immediately enact regulatory changes that will help to reverse this threat by reducing the growth of antibiotic resistant bacteria.

The report, titled "When Antibiotics Stop Working," finds antibiotics are not as effective as they once were because bacteria are adapting to them.  These resistant bacteria are germs that can cause infections like pneumonia, urinary tract infections, or skin infections.  For example, ten years ago one dose of antibiotics could have effectively treated a child suffering from strep throat, but it is now becoming more common for a child to have repeated strep throat infections, and for these to develop into more serious consequences, like scarlet fever.  And if the first-choice antibiotic fails, physicians are forced to prescribe new ones with harsher side effects.

It is important that everyone who has access to antibiotics shift perspectives and begin to use them as responsibly and prudently as possible.   Using antibiotics more carefully, for example, means closing the loophole that allows farmers to feed these medications to their livestock without prescriptions simply to promote growth. And it means keeping better track of patients' antibiotic histories so that physicians can prescribe the medication most likely to work.

Among the recommendations:

• Develop a system for farm industry surveillance to keep track of the identities and quantities of antibiotics being purchased, and those being moved into or out of Ontario. Currently, surveillance of antibiotic movement does not exist in the province;
• Establish an independent institution to develop and maintain optimal antibiotic use guidelines that Ontario physicians can use to guide their practice, particularly when dealing with resistant bacteria and less familiar antibiotics.
• A veterinary prescription-only standard of access to antibiotics for animals must be instituted;
• Amend the Food and Drugs Act and its Regulations to close the loophole allowing farmers to import antibiotics for their own use.

Quote:
Ontario's doctors are concerned about the growing rate of antibiotic resistant bacteria. Patients are at risk of becoming sicker, taking longer to recover and it some cases dying from previously treatable diseases.  Data shows that we can reduce antibiotic resistant bacteria when the use of antibiotics is modified.  Adopting the recommendations in the report will help us achieve this.

Dr. Doug Weir
President
Ontario Medical Association

Key Recommendations:

• The Government of Ontario must develop a system for farm industry surveillance to keep track of the identities and quantities of antibiotics being purchased, and those being moved into or out of Ontario. Currently, surveillance of antibiotic movement does not exist in the province.
• Surveillance should be established in areas where it does not exist (agriculture) and strengthened in areas where it does exist (medicine) in order to collect data and gain a firmer understanding about antibiotic resistance in both humans and animals.
• Electronic health records should be utilized to allow physicians to compare patients' past prescriptions and diagnoses. This would reduce variability and allow physicians in the community, hospital, emergency department, or long-term care facility to make optimal decisions about which antibiotics to prescribe to patients.
• An independent institution should be established in conjunction with one of Ontario's medical schools to use currently available data to develop and maintain optimal antibiotic use guidelines that physicians in Ontario can use to guide their practice, particularly when dealing with resistant bacteria and unfamiliar antibiotics.
• Ontario should ban the prophylactic or growth-promoting use of antibiotics, whether extra-label or indicated, in animal husbandry. This step is fundamental to preserving the effectiveness of antibiotics.
• A veterinary prescription-only standard of access to antibiotics for animals must be instituted. The province should require a veterinary prescription and/or supervision of the use of all antibiotics on farms. The current practice allows for unsupervised, unscientific, and ultimately dangerous application of important medications.
• Amendments to Ontario's Livestock Medicines Act must be made to close the "own use" loophole created by the Food and Drugs Act and its Regulations, to ensure that large volumes of antibiotics cannot be freely imported into the province and be applied to animals en masse without surveillance or regulation.
• The federal government must engage in antibiotic conservation and amend the Food and Drugs Act and its Regulations to close the "own use" loophole. People importing antibiotics for any reason should all be held to the same standards, and surveillance should be established to allow the collection of data about which drugs are entering our country and what their intended use is.
• The federal government should provide funding for research, strengthened surveillance, and educational campaigns focused on antibiotic resistance. There is a dearth of community-based surveillance of organisms and resistance patterns, and this must be rectified.
• Everyone who has access to antibiotics must act responsibly and prudently with them. Patients must work alongside physicians to modify the expectations of receiving antibiotics for certain infections, even if patients have received antibiotics in the past for similar complaints. Physicians, patients, allied health-care professionals, and dispensing parties (pharmacists), need to be aware of the importance of this issue and incorporate that knowledge into their own practice and use.

SOURCE: Ontario Medical Association

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