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British Columbians use more antibiotics than northern Europeans, and this could be a problem because overuse of antibiotics contributes to the emergence of antibiotic-resistant microorganisms, according to a study by researchers at the University of British Columbia and their colleagues. The study appeared in the June 15, 2004 issue of Clinical Infectious Diseases.
The study measured antibiotics dispensed in British Columbia and several European countries, and it made specific comparisons between British Columbias and Denmarks usage. Common microorganisms that cause respiratory and urinary tract infections are shown to be developing increasing resistance to antibiotics. The unnecessary use of these antimicrobials just serves to shore up the microorganisms mounting resistance.
France and Greece have higher per-capita consumption of antibiotics than British Columbia, but the Canadian provinces antibiotic use was consistently higher than that of northern European countries (such as Sweden, Denmark and the UK). Between 1997 and 2000, British Columbias usage of the major classes of antibiotics was about 50 percent higher than Denmarks. In both countries, antibiotic use peaked during January through March, and females in British Columbia used 17 percent more antibiotics than males.
Why physicians over-prescribe antibiotics can be a complex matter, according to Dr. David Patrick, of the University of British Columbia Centre for Disease Control, who is lead author of the study. There is still a tendency to prescribe for symptoms that are most often viral in origin such as the common cold, he said. The problem is that antibiotics treat bacterial, not viral, infections. Doctors who are pressed for time may give in to patients demands for antibiotics, rather than explaining why they are unnecessary.
In addition, North American doctors may have different standards for treating some common infections than in Europe. Many North American physicians will treat middle ear infection on site [with antibiotics], whereas northern European doctors will do so only if it fails to resolve with decongestants, Patrick said.
Furthermore, he said, in North America, some guidelines for antibiotic usage may be funded by the drug-manufacturing companies that have a vested interest in getting physicians to prescribe their products. Northern Europe has made efforts to cut back on unnecessary antibiotic use, such as generating drug use guidelines without the aid of industry funding.
Other ways of reducing antibiotic overuse, said Patrick, include educational initiatives directed at both doctors and patients. North American doctors need education to emphasize the major clinical syndromes where drugs are overused, he said, and the public needs to know when they DONT need drugs, such as when they have colds, and other means to reduce the spread of infections, such as hand washing.