The last post was about animals so let’s get to some human data from the 2017 Canadian Antimicrobial Resistance Surveillance System report.
In 2016, 247,014 kg of antibiotics were dispensed, most (>200K kg) through pharmacies, with ~40K kg through hospitals. Overall, ~92% of defined daily doses of antibiotics were dispensed through pharmacies.
- This is another example why there needs to be more work on community-level antimicrobial stewardship programs. Hospitals are an important place to address antimicrobial use, but the community can’t be ignored.
A couple hundred thousand kgs of antibiotics isn’t cheap. The total cost in 2016 was ~$766 million.
- How much of that was unnecessary isn’t known. However, even if we just think about antibiotic cost savings (ignoring resistance, complications and various other potential problems), reducing antibiotic use can have a big financial impact.
625 prescriptions were dispensed in the community for every 1000 people.
- This number has been pretty stable over the past few years, but varies across the country.
When provinces and territories are compared, Newfoundland is gets the dubious distinction of leading the way in prescription rates per 1000 people, at 954. The Territories (a combination of the Northwest Territories, Yukon and Nunavut) had the lowest rate, at 280/1000.
The most common drugs have remained pretty stable. Amoxicillin was the most common drug, followed by azithromycin and cephalexin.
Prescription rates for kids < 14 yrs of age have been decreasing since 2011.
- Maybe that’s due to increased awareness (both physician and parent) about how often some common problems like ear infections are viral and don’t need antibiotics.
Some good news. Some concerning news. Lots of room for improvement….and an indication of the need for more extensive antimicrobial stewardship programs.