Antibiotic use finally going down, just not quickly enough, MD says
Doctor says up to half of prescriptions in N.L. are unnecessary
The latest statistics suggest Newfoundland and Labrador has decreased its use of antibiotic prescription by five per cent in the past year, but one doctor says the province still has a long way to go.
"We don't really know why numbers are down but we still focus on the problem, which is to say we love antibiotics in this province for some reason," said Dr. Peter Daley, an infectious disease specialist and associate professor of medicine at Memorial University.
We are talking about this as the global warming of medicine.- Dr. Peter Daley
Accord to health advocacy group Quality of Care NL, the province still has the highest rate of antibiotic use in the country, and Daley believes almost half of all antibiotic prescriptions in the province are still unnecessary.
"We have so far to go."
Most of the antibiotics in the province are being used for respiratory tract infections, according to Daley. In order to prevent antimicrobial resistance, a condition in which bacteria become resistant to antibiotics, that needs to stop, he said.
"We know that most respiratory tract infections in the outpatient setting are minor and do not require antibiotic treatment," he said.
Provincial Health Minister John Haggie said antimicrobial resistance will lead to superbugs. He added the biggest challenge in Newfoundland and Labrador is drug-resistant tuberculosis.
"It's coming, and we're starting to see — even when I was in clinical practice — a rise in antibiotic-associated illnesses and death," Haggie said.
"So those two trends need to be managed."
Not only do respiratory tract infections not require antibiotic treatment, Daley said it could even be harmful to one's body.
In 2018, said Daley, there were 14,000 deaths in Canada associated with antimicrobial resistance.
"We are talking about this as the global warming of medicine, which is to say we are unknowingly contributing towards a large and slow ecological shift, which means that our first-line drugs no longer work."
Patients and physicians to blame
Daley said it comes down to physicians over-prescribing the medications and patients trying too hard to obtain them. He said patients often go to their doctors and demand antibiotics. If they can't get them, some will threaten to see another doctor.
"We are trying to encourage physicians to say to the patient, 'You will do well without this antibiotic.' General practitioners have to take a lot more time to explain this to patients," he said.
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Doctor-patient miscommunication is one reason why Daley, alongside Quality of Care NL, is hosting a public forum on antibiotics on Nov. 20 at MUN. Haggie will be a speaker at the forum.
Haggie said the province is aware the antibiotics issue needs to get under control. He added a lot of education on the problem is aimed at medical prescribers, but the province also has a problem with patient expectations.
"People go to a doctor and expect a pill when they're unwell, and that may not be the best thing," he said.
"If you have a viral illness an antibiotic is not going to do you any good. Indeed, that extra use of antibiotics ultimately will do all of us some harm."
With files from On The Go