Antimicrobial resistance programs in Canada 1995-2010: a critical evaluation

Area of Science:

• Public Health
• Infectious Disease Control
• Health Policy

Background:

• Canada initiated systematic antibiotic resistance control efforts in 1997 post-national Consensus Conference.
• The Canadian Committee on Antibiotic Resistance (CCAR) was established, alongside other organizations addressing antimicrobial resistance (AMR).
• A critical evaluation of major Canadian AMR programs and their core components was lacking.

Purpose of the Study:

• To critically evaluate major national antimicrobial resistance (AMR) programs in Canada.
• To assess the components and impact of key AMR initiatives.
• To identify gaps in leadership and coordination of AMR activities.

Main Methods:

• Data was gathered from multiple sources on four major national AMR programs.
• Program components were assessed using a framework adapted from the International Forum on Antibiotic Resistance.
• Prescription data trends were analyzed to evaluate the impact of AMR programs.

Main Results:

• Most programs utilized similar tools, with the Do Bugs Need Drugs Program (DBND) uniquely targeting daycares and schools.
• Surveillance programs for antimicrobial-resistant pathogens exhibited limitations and biases.
• A 25.3% decrease in oral antibiotic prescriptions occurred since 1995, notably with reductions in beta-lactams, sulfonamides, and tetracyclines, coinciding with CCAR and DBND initiatives.

Conclusions:

• Despite a substantial decrease in oral antibiotic prescriptions, a significant gap in leadership and coordination for AMR activities remains in Canada.
• National programs like CCAR and DBND have been associated with positive trends in antibiotic stewardship.
• Further efforts are needed to enhance cohesive national strategies for antimicrobial resistance control.