Ear, throat and skin infections that were once easy to treat are becoming serious threats to Canadians. The rise of antibiotic-resistant bacteria is the reason and it's one of the biggest health issues facing the country, the Ontario Medical Association warns.
The OMA says in a report released on Wednesday that continued federal and provincial inaction on the issue is making the problem worse. It issued a series of recommendations, including improved surveillance and tightened controls on the use and distribution of antibiotics, to reduce the threat.
One of the main areas of concern is the widespread use of antibiotics in animals, which is leading to an increase in drug-resistant bacteria that can pose a risk to both animals and humans.
"If we don't do something soon, we're on the edge of returning to an age where people are going to die from what are really routine infections," said Dr. Doug Weir, president of the OMA. "It's already a crisis now and we really need to do something soon to turn the tide."
Outbreaks of resistant bacteria, such as methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus, have become common in health-care institutions across the country, particularly among older patients or those with weakened immune systems. Estimates suggest as many as 12,000 Canadians die from these hospital-acquired infections each year while hundreds of thousands fall ill as a result.
However, drug resistance can also easily affect healthy young people with common infections, such as in the ear or urinary tract.
Antibiotic resistance means that those patients are increasingly being treated with less-common antibiotics that may cause more side effects or require longer, more complicated treatment.
Unless action is taken to curb the rising incidence of drug resistance, Weir and others in the medical community say, there is good reason to believe the day will come when antibiotics will be powerless against many once-treatable infections.
Patients "are getting sicker than they used to from bacterial infections that have been treatable for many decades," the OMA report says, noting that strep throat, which was once easily treatable, is now causing multiple infections in children and leading to complications, such as scarlet fever, more often.
One of the major underlying causes is the overuse of antibiotics. When antibiotics are overused and given to patients when they are not needed, bacteria can adapt and become resistant to the drug. Once bacteria develop resistance to one antibiotic, they can easily become resistant to others.
Regulations prohibit important first-line human antibiotics from being given to animals. However, the OMA warns that farmers who use other antibiotics to promote growth or prevent illness in animals are contributing to the problem of drug resistance because many animal and human drugs belong to the same family. The problem is so significant that the U.S. Food and Drug Administration is moving to introduce bans on the use of growth-promoting antibiotics if they are also used in human medicine.
Mike Dungate, executive director of Chicken Farmers of Canada, said his industry is committed to the issue of drug resistance. "We are pro-active on antibiotic resistance," he said. "We're not waiting around for the Ontario Medical Association to pronounce on something."
Dungate also disputed the idea that antibiotic use in animals is contributing to the overall problem of drug resistance in humans, saying many of the studies showing a link have been flawed. He also noted that most antibiotics used for "sub-therapeutic" purposes – such as boosting weight gain or preventing illness – are not used in human medicine.
The OMA report points out that many drugs used in animals can be related to human antibiotics and that adding them to animal feed in order to increase weight gain increases the risk of drug-resistant bacteria forming.
Andrew Simor, head of microbiology and infectious diseases at the Sunnybrook Health Sciences Centre in Toronto, added that there is a "tremendous" amount of evidence showing a relationship between antibiotic use in animals and the risk of drug-resistant bacteria.
The OMA report makes several recommendations, including:
The development of a farm surveillance system to track antibiotics being purchased and moved in or out of the province.
The creation of a surveillance system to track drug resistance in animals and a strengthening of the existing system for humans.
A ban on the use of antibiotics to promote growth in animals.
Federal investments in research, surveillance and public education to improve awareness of the problem and develop better strategies.
Prudent use of antibiotics by both physicians and patients, who should not automatically expect to receive an antibiotic prescription.