Choose wisely when it comes to antibiotics

It’s cold and flu season in New Brunswick, and that means many of us will be under the weather at times in the coming weeks and months.

When it comes to managing cold and flu symptoms, the New Brunswick Medical Society (NBMS) and Choosing Wisely New Brunswick (CWNB) want to remind New Brunswickers that antibiotics simply do not work against common cold and flu viruses.

Colds, coughs, sore throats, and flu-like illnesses are caused by viruses. Antibiotics do not combat viral infections.

This may sound old fashioned, but the best way to treat most colds, coughs, or sore throats is with plenty of fluids and rest. There is no quick fix; most of these illnesses will get better without antibiotics in two to three weeks.

Yet despite what we know about antibiotics, we continue to see news headlines related to the spread of antimicrobial resistance. Last week, a study (When antibiotics fail: The growing cost of antimicrobial resistance in Canada) was released by the Council of Canadian Academies estimating the percentage of bacterial infections resistant to treatment is likely to grow from 26 per cent in 2018 to 40 per cent by 2050.

This increase is expected to cost Canada 396,000 lives, $120 billion in hospital expenses, and $388 billion in gross domestic product over the next three decades.

This week, the World Health Organization (WHO) recognizes Antibiotic Awareness Week (Nov. 18-24) which aims to “increase global awareness of antibiotic resistance and to encourage best practices among the general public, health workers, and policy makers to avoid the further emergence and spread of antibiotic resistance.”

As WHO notes, antibiotics have served as the cornerstone of modern medicine. However, like many great resources, persistent overuse and misuse of antibiotics have encouraged the emergence and spread of antibiotic resistance, which occurs when microbes, such as bacteria, become resistant to the drugs used to treat them.

Simply put, by overusing or misusing antibiotics, we are increasing the likelihood that bacteria, viruses, and fungi will evolve to the point where antibiotics are useless against them.

It is estimated that inappropriate antibiotic prescriptions make up more than 30 per cent of all prescriptions in Canada and 50 per cent of prescriptions for respiratory infections. Across the country, a growing number of infections are not responding to antibiotics including tuberculosis, gonorrhea, and urinary tract infections.

Currently, the problem costs the national health-care system $1.4 billion a year and by 2050, that figure is projected to grow to $7.6 billion.

The report by the Council of Canadian Academies — completed at the behest of the Public Health Agency of Canada — also shows that from 250,000 resistant infections that occurred in Canada in 2018, 14,000 people died. It estimates that up to 40 per cent of these deaths would not have occurred if the infection was susceptible to first-line antimicrobials.

The Public Health Agency of Canada advises that the best way to combat antimicrobial resistance is to stay healthy in the first place. That means maintaining proper hygiene, including frequent hand-washing, using soap or hand sanitizer for at least 20 seconds.

The NBMS and CWNB have partnered to support changes for more appropriate antibiotic use to help preserve this important resource for our future in New Brunswick.

We are participating in Antibiotic Awareness Month through a social media campaign aimed at informing New Brunswickers about the dangers of antibiotic overuse and misuse. We want to encourage patients and health-care providers to have conversations about appropriate use of antibiotics and provide health-care providers with new tools and practice guidelines to support optimal prescribing.

Communication is key. We all have a role to play, and we urge you to participate by choosing wisely, spreading these important messages, and by talking to your physician or health-care practitioner.

Dr. Chris Goodyear, FRCSC, is a general surgeon in Fredericton and the president of the New Brunswick Medical Society.