Survey reveals antibiotic resistance and antibiotic prescriptions on the rise

Toronto, ON – New data indicates that while some rates of antibiotic resistance are stabilizing in Canada, others continue to rise. And while Canada remains a world leader in the fight against antibiotic resistance, the rate of antibiotic prescriptions is on the increase.

The annual National Report Card on Antibiotic Resistance was organized by the National Information Program on Antibiotics (NIPA), a coalition of eight leading Canadian physician, pharmacist and patient organizations created 10 years ago to educate Canadians about the appropriate use of antibiotics.

Bacteria can grow resistant to antibiotics because of the overuse or inappropriate use of these medicines, resulting in antibiotic resistance.

“Rates for penicillin-resistant Streptococcus pneumoniae (also called Strep pneumo) have stabilized over the past five years, increasing only marginally from 14.8 per cent in 2004 to 15.0 per cent in 2005,” says Dr Donald Low, microbiologist-in-chief at Mount Sinai Hospital in Toronto and principal investigator with the Canadian Bacterial Surveillance Network (CBSN), which collected the data.

“But we need to be concerned with other classes of antibiotics, including the macrolides, which are commonly used to treat respiratory infections in children and adults. Rates for macrolide-resistant Strep pneumo have increased steadily since 1999. Strep pneumo resistance to a commonly-prescribed macrolide called erythromycin rose to 19.3 percent in 2005, up from 18 percent in 2004. In 1999, macrolide resistance in Canada was less than 10 percent,” he says.

Strep pneumo is the leading infectious cause of disease and death worldwide and the most common bacterial cause of community-acquired infections such as bronchitis, sinusitis and pneumonia. It is also responsible for most cases of middle ear infections and bacterial meningitis in children.

For purposes of year-to-year comparison, the CBSN routinely evaluates antibiotic resistance to Strep pneumo.

The report also examined another class of antibiotics called quinolones, and in particular levofloxacin, primarily used to treat respiratory and urinary tract infections. The rate of Strep pneumo resistance to levofloxacin remained relatively unchanged, dropping slightly from 1.5 percent in 2004 to 1.4 percent in 2005.

In 2005, the penicillin class showed a slight increase in the rate of prescriptions. This represents a departure from the steady downward trend between 1994 and 2004, when the prescription rate was cut almost in half.

In 1997, Health Canada set a five-year target to reduce community antibiotic prescriptions by 25 percent. To date, community antibiotic prescriptions have decreased by only 9 percent. The Report raises concerns about the increase in the overall rate of antibiotic prescriptions from

61.9 prescriptions per 100 Canadians in 2004 to 63.5 in 2005, an increase of almost 3 percent.