We are witnessing a growing crisis in Canada and around the world as antibiotics and other medications lose their effect on infectious diseases.
The problem goes by the scientific name, ‘Antimicrobial Resistance’ (AMR). Antimicrobial medications are losing effectiveness because Microbes are developing Resistance to them.
What Canadians need to know is that our actions make a difference. We can all help slow AMR.
What is AMR?
Antimicrobial resistance occurs when microbes, such as bacteria, viruses, fungi, and parasites, develop the ability to resist the effects of medications that used to work against them. This means that many treatments become ineffective, leading to infections that are hard to treat and more likely to spread to others.
AMR affects antimicrobials, including antibiotics, antivirals, antifungals, and antiparasitics. These agents are crucial for medicine and agriculture where they are used to prevent and treat infectious diseases in humans, animals, and plants. AMR often develops faster than new antimicrobials can be developed. This leaves us with fewer safe alternatives to fight infections.
Every infection-drug combination is affected by AMR differently. For common combinations, AMR is tracked by labs and public health officials to understand how resistant microbes are, how many medications are impacted, and how widespread the resistance is. This information helps healthcare providers assess which treatments remain effective for their patients.
The medications most frequently used to treat infections are often the most affected by AMR. When medications used as standard therapy lose effectiveness the consequences can be greater because alternative medications are often less effective, more toxic, and more expensive for our healthcare system.
The bacteria responsible for gonorrhea have developed resistance to several antibiotics. Today, public health officials are concerned that highly resistant strains that circulate globally could become established in Canada. 1
What drives AMR?
AMR happens naturally as microbes adapt to survive. But misuse and overuse of antimicrobials accelerates the rise in AMR.
Antibiotic use is a major driver of AMR. Antibiotics are widely used by Canadians and have an important role in combating many serious infections caused by bacteria.
Approximately 30% to 50% of antibiotics prescribed for upper respiratory tract infections are unnecessary.2 Many colds and sore throats are caused by a virus, which antibiotics are not effective against. Also, many bacterial infections improve without antibiotics.
If you take an antibiotic for a bad cold, you might ask: “What’s the harm?” The reality is improper use of antibiotics can encourage the growth of resistant bacteria.
When you take an antibiotic, it kills many microbes. Mainly those that are more susceptible to the medication, while more resistant microbes may survive. Taking a lower dose or stopping the antibiotic sooner than recommended can allow more resistant microbes to survive. The resistant microbes that live can multiply and gain a competitive advantage over the other microbes that the antibiotic was able to kill. Next time you take antibiotics, when you really need them, they may not work.
“The more antibiotics are used to treat trivial conditions, the more likely they are to become ineffective for treating more serious conditions.” (UK Antibiotic Guardians)
What this means for you
As a result of AMR, infections are becoming more frequent, harder to treat, and more deadly. Common infections like urinary tract infections, bacterial pneumonia, and gonorrhea are among the conditions that have become difficult to treat in Canada today because of AMR.
A recent report* estimated that 26%, or about 1 in 4 infections in Canada are already resistant to the drugs generally used to treat them, and 5,400 people die each year due to AMR infections. By 2050, these figures are expected to grow to upward of 40% resistance and 13,700 deaths annually.
The consequences of AMR are even greater when we consider the safety of health services. Without effective antibiotics, other treatments, including routine surgeries like joint replacements and Caesarian sections, kidney dialysis, and chemotherapy also become risky.
What you can do
1
Do your best to prevent infections
Help prevent and stop the spread of infections. Fewer infections lead to less use of antibiotics overall, reducing the pressure on microbes to develop resistance.
Reducing antibiotic use also reduces risks for other harms from these potent medications, like allergic reactions, side-effects, and disruption to your body’s microbiome – the helpful microbes important for healthy digestion and immunity.
Everyone
- Wash your hands thoroughly and regularly, and stay up-to-date with recommended vaccinations.
Healthcare Providers
- Wash your hands before and after every patient encounter, and promote immunization.
2
Guard against antibiotic overuse
To slow AMR, help reduce unnecessary use of antibiotics, a major driver of resistance. Remember, antibiotics are not effective against viral infections like colds or the flu, and many bacterial infections, like mild cases of sinusitis, bronchitis, and some sore throats, often resolve on their own without antibiotics.
Everyone
- Talk to your healthcare provider about whether or not you need antibiotics, their risks, and options for symptom relief. Plenty of fluids and rest are the best remedies for most colds, coughs, and sore throats.
Healthcare Providers
- Consider non-bacterial causes of your patient’s symptoms. Ensure that appropriate bacterial cultures are collected before prescribing antibiotics.
- Talk to patients about when antibiotics can be helpful and when they are unnecessary. Use patient education tools like a ‘viral prescription’ to explain why an antibiotic would not be helpful and give advice on how to relieve symptoms.
3
Learn about responsible antimicrobial use
When an antibiotic or other antimicrobial is necessary and prescribed, we can all help ensure appropriate use. Healthcare professionals, including pharmacists and nurses, as well as patients and their personal caregivers need to be aware and part of conversations about responsible practices.
Everyone
- Take antibiotics only when prescribed for you and as directed. Following instructions on the dose and duration helps eliminate bacteria and limit resistance.
- Do not share antibiotics prescribed for you with others or save them for the next time you are ill.
- Return unused antibiotics to the pharmacy. Do not dispose of antibiotics in the sink, toilet, or trash to reduce antimicrobial contamination in the environment, which contributes to AMR.
Healthcare Providers
- Consult guidelines on antimicrobial therapy. Consider the right drug, at the right dose, for the least duration proven to be effective.
- Document the indication for a prescription and a review date.
- Seek information on local resistance patterns to make informed decisions about antimicrobial use.
Explore our Resources page to learn more about antimicrobial resistance and how to use antibiotics appropriately.
AMR Aware Canada supports the Pan-Canadian Action Plan on AMR and World AMR Awareness Week.
- Government of Canada. Health Infobase. Antimicrobial Resistance (AMR) Seasonal Update. Drug-resistant Neisseria gonorrhaeae infections. https://health-infobase.canada.ca/carss/amr/results.html?ind=12 ↩︎
- Fleming-Dutra KE, Hersh AL, Shapiro DJ, et al. (2016) Prevalence of inappropriate antibiotic prescriptions among US ambulatory care visits, 2010–2011. JAMA 315:1864–73. ↩︎