How much is too much? N.L. dispenses the most antibiotics in Canada

A new public health campaign says enough is enough on antibiotic use in Newfoundland and Labrador.

Choosing Wisely NL, a group watching for unnecessary medical treatments in the province, is launching a campaign to ask doctors and patients to reconsider whether their antibiotic prescriptions are really necessary.

Dr. Natalie Bridger

Dr. Natalie Bridger says antibiotic overuse comes with serious side effects. (Sherry Vivian/CBC)

The group says the “overuse” of antibiotics in Newfoundland and Labrador — which dispenses more daily doses per capita than any other province in Canada — can actually cause more harm than good.

“We know that antibiotic use, when it’s not necessary, does cause harm,” says Dr. Natalie Bridger, a pediatric infectious diseases specialist and assistant professor at Memorial University.

“It can cause harm to the person who’s taking the antibiotics unnecessarily, but also causes harm to society for creating more drug-resistant bugs.”

Leading the country

A 2016 report by the Public Health Agency of Canada says that Newfoundlanders and Labradorians on average take more antibiotic drugs than residents in any other province in Canada.

According to the study, community pharmacies in the province dispensed 33 per cent more antibiotics per capita in 2014 than in Saskatchewan, the second highest user.

Antimicrobial use in 2014 graph

A report by the Public Health Agency of Canada of Canada suggests antimicrobial use in Newfoundland and Labrador is higher than any other in part of the country. The above graph measures defined daily doses of antimicrobials per resident passed out by community pharmacies in 2014. (Public Health Agency of Canada)

“We’re different culturally, we have different disease patterns, people have different genetic makeups,” Bridger told CBC’s Here & Now.

Bridger said a rigorous analysis is required to figure out just why prescribing is so high in the province, but she is sure of one thing.

“I don’t think that we have 30 per cent more bacterial infections than the rest of the country.”

Antibiotic overuse comes at a cost, Bridger said. Helpful bacteria in a human body is killed, and some damaging bacteria will become more drug-resistant by evolving and adapting.

And when people get unnecessary prescriptions they suffer the side effects for no reason — which could be minor, like rashes, or serious, like allergic reactions, she said.

However, they’re not harmless. When we don’t #choosewisely about antibiotics, we run the risk of damaging our health. Be #healthcareful!

Posted by Choosing Wisely NL on  Tuesday, November 22, 2016

While the statistics measure how many antibiotics are dispensed at pharmacies, the province’s Council of Independent Community Pharmacy Owners says the problems begin earlier than that.

Sue Kelland-Dyer, the group’s executive director, says overuse of antibiotics in Newfoundland and Labrador often start with doctors.

“In order to get at the problem, we have got to get at…the beginning of the problem, which is the actual prescriber.”

Kelland-Dyer says the provincial government should set up a system to monitor prescriptions as they are written.

“Pharmacies absolutely see [overuse] as real, we see the results of that every day at the counters in pharmacies.”

Changing the conversation

Choosing Wisely NL wants doctors and patients to rethink their antibiotic use.

The campaign hopes to start the conversation, reduce unnecessary prescriptions in the province and reduce the spread of antibiotic-resistant bacteria.

But Bridger said good advice can still be hard to follow.

“I have definitely personally been faced with people demanding antibiotics in the past, and I haven’t been perfect with my prescribing practices,” she told CBC Radio’s On The Go.

“I definitely have given antibiotics in the past that have not been necessary.”

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