Not all “bugs” need drugs, according to the Antimicrobial Stewardship Committee at the Lake of the Woods District Hospital.

This week has been chosen by the World Health Organization as their Antimicrobial Awareness Week, a week to promote the safe use of antibiotics, and similar antimicrobials. The Kenora hospital's committee says that while antibiotic resistance can occur naturally, the misuse the antibiotics is accelerating this process at an alarming rate and it now considered to be one of the biggest threats to global health today.

The issue for the committee, is that a growing number of infections are becoming harder to treat as the antibiotics used to treat them are becoming less effective. This can lead to longer hospital stays, higher medical costs and increased mortality.

Lindsay Williams, Clinical Pharmacist and co-chair of the Antimicrobial Stewardship Committee, spoke about the reason behind the committee and what they aim to do.

“We aim to optimize the use of antimicrobials to achieve the best patient outcomes, and reduce the risk of infection in the hospital. The week is to promote the safe use, and non-use of antimicrobials,” she said.

Dr. James Kerry MacDonald, Chief of Staff and Lab Director, spoke about the issue.

“It’s been something that has been ongoing for decades. The rise of resistance has been far faster than the production of antimicrobials. It’s an ongoing activity that we’ve been doing for a very long time. The committee is to optimize the use of antimicrobials, and to decide when not to use them so that there’s as little evolutionary pressure on micro-organisms to encourage resistance,” he said.

The Antimicrobial Stewardship Committee at LWDH was founded in 2011 as a required organizational practice of Accreditation Canada. The Team consists of a physician lead (Dr. Kerry MacDonald), pharmacist lead (Lindsay Williams), microbiologist (Tracy Munn), infection prevention and control practitioner (Lynn Ronnebeck/Janet Paulson), manager of quality and risk (Erin Mudry), front line nurses (Marg Tella and Joelle Thompson) and other members.

The Committee aims to optimize the 5 D’s of Antimicrobial Stewardship:

1. Diagnosis – does the condition require antibiotic therapy?

2. Drug – is the drug appropriate for the infection being treated?

3. Dose – is the dose correct?

4. Duration – how long should the drug be used for?

5. De-escalation – can the drug be narrowed in spectrum and/or changed from IV to oral?

Statistics from the Canadian Institute for Health Information showed that in 2015, more than 25 million courses of antibiotics were prescribed in Canada. The data reveals that every day, roughly 20 out of 1,000 Canadians take a dose of antibiotics. Canadian clinicians prescribe 33 per cent more antibiotics than most countries. Internationally, roughly 3 out of 5 antibiotic prescriptions were for diagnoses considered inappropriate, such as common colds and related symptoms. 

The committee offered tips for residents to help reduce antibiotic resistance:

- Do wash your hands often – to help prevent the spread of infections.

- Do keep your vaccinations up to date – to prevent you from getting sick in the first place.

- Do practice safe sex – to prevent sexually transmitted diseases.

- Do stay home when you are sick – to prevent spreading germs to others.

- Do take antibiotics as prescribed (at the right times and for the full duration) – to prevent bacteria from becoming resistant.

- Don’t pressure your doctor for antibiotics – your doctor is the expert, if they do not think you need an antibiotic, you likely don’t. Antibiotics WILL NOT work on viruses.

- Don’t share antibiotics with anyone – not all antibiotics work for all infections, taking one that is not effective against a certain bacteria can cause other bacteria to become resistant to it.

- Don’t use antimicrobial hand soap – there is no evidence to show that it works better than regular hand soap for day-to-day use and it can also lead to antimicrobial resistance.

Antimicrobial Awareness Week runs until November 17. 

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