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Newfoundland and Labrador leads country in antibiotic usage

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‘This is a major concern for me,’ infectious-disease specialist says

Prescribers in this province are approaching nearly a one-for-one prescription rate when it comes to antibiotic use.

A recently completed graphic from the Canadian Antimicrobial Resistance Surveillance System (CARSS) shows Newfoundland and Labrador prescribes 33 per cent more antibiotics than the second-highest province in Canada (Saskatchewan).

Alarmingly, more than 900 of every 1,000 Newfoundland and Labrador residents received antibiotic prescriptions last year.

Dr. Natalie Bridger, a member of Choosing Wisely Canada, an associate professor of pediatrics at Memorial University in St. John’s and an infectious-disease specialist at Eastern Health, is working as part of an initiative that will see health-care professionals use data gathered from a recent study and formulate a remedy.

“This is a major concern for me and it should be for the public, too,” Bridger said.

“I find it hard to believe there are 33 per cent more bacterial infections here.”

Bridger said the premise of the peer-to-peer program is to give prescribers the tools to deal with the issues at hand and not by handing out an antibiotic prescription.

“(Eastern Health family doctors) have received a report on antibiotic prescription practices. Hopefully they are reviewing it. This feedback, a self-reflection of your own prescribing patterns, will be important,” she said.

“A team will be going around to doctors and speaking to them cognizant of the challenges doctors face on a day-to-day basis. They are going in as a coach, not a lecturer. Things have changed in recent years. The pendulum has swung and we now understand the consequences of over-prescribing.”

In the past, when people went to the doctor with sore throats, earaches, colds, etc., it was easy for doctors to just prescribe an antibiotic and move to the next patient.

The antibiotics don’t work on those ailments, and in fact they do more harm than they fix.

“The more antibiotics you take, your body steadily becomes resistant to antibiotics, so when you actually need one, they may not work and put you in peril of far worse than your initial prognosis.

“You go to the doctor when you are sick. The doctor has to acknowledge the patient is sick and there are things that can make you feel better. … An antibiotic is not one of them,” Bridger said.

“Sometimes, if you are going to take one and feel better in three days, you would be better in three days anyway. Therefore, why take it?”

Choosing Wisely Canada’s outlook is comprised of evidence-based data that can be used as a tool to empower physicians to further empower their patients with the correct knowledge of what they need — or don’t need — and why.

“If you truly need an antibiotic, there is risk and benefit involved.”

She said if a person doesn’t need an antibiotic, there is the issue of putting something toxic in the body without any added benefit to the patient.

Bridger speculated that because people are living longer, it gives the body more time to build up resistance if they are exposed to unnecessary antibiotic use.

As an example, she said, a lot of older patients are diagnosed with urinary tract infections (UTI) and in many cases are misdiagnosed due to the normal bacteria that appears in their urinary tract. Their doctor thinks they have a UTI and prescribes an antibiotic when they don’t need it, she said.

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