New BC program seeks to reduce antibiotic use

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The prevention of deadly infections is as simple as washing your hands, and in learning the differences between viruses and bacteria to know when and how to use antibiotics.

The lessons are part of a province-wide program called, Do Bugs Need Drugs?, aimed at children, families, and health care professionals to address antibiotic resistance. In 1998, the program was developed in Alberta by Dr. Edith Blondel-Hill and has since been adopted by communities in Northern Saskatchewan, Manitoba, Ontario, and now by British Columbia.

The BC Centre for Disease Control (BCCDC) along with Perry Kendall, provincial health officer, launched the Do Bugs Need Drugs? program in mid-January with hopes of "educating the public about the issue of growing antibiotic resistance, and that it is a serious one," he told Raven's Eye. The BCCDC will receive nearly $1.4 million over three years from the province to co-ordinate this program throughout B.C.

"This program is aimed at improving appropriate prescription of antibiotics by basically reducing the demand of antibiotics and changing the prescribing practices of physicians a bit," said Kendall.

The program includes an interactive educational component that will be made available for preschool children and those who are in Grade 2. They will learn the difference between viruses, bacteria, when antibiotics should be used, and the importance washing their hands to stay healthy.

According to Blondel-Hill, they have already provided continuing medical education courses for doctors and pharmacists in Alberta. In addition, this program has provided education to nurses, including a big component of First Nation public health nurses.

"Our program is to address antibiotic resistance, which has resulted from the overuse of antibiotics, mostly for respiratory tract infections. Therefore, people are now dying of infections because we can't treat them anymore," said Blondel-Hill, medical director of the program and medical microbiologist and an infectious disease specialist at BC Children's Hospital.

Blondel-Hill describes viruses as tiny little germs that have to live within the host, whereas the environment that we live in is filled with bacteria.

"The vast majority of bacteria are good," she said. "We have bacteria on our skin to protect us; we have bacteria in our intestines to help with digestion; and we have approximately 500 different species of bacteria in our mouth to help clean our teeth. Most are good. There are just a few odd bacteria that can cause diseases in humans."

She explained that bacterial diseases tend to be what she calls, opportunistic, which means bacteria don't usually, "bother us if we live in good harmony with them. But the most common thing that happens is that we get a virus and sometimes our immune system can't fight them off."

Viral infections include colds, flu, croup, laryngitis, chest colds and most sore throats. These type of infections usually get better in four to five days, but it may take as long as three weeks to fully recover. Viral infections are more contagious than bacterial infections. If more than one person has the same illness, odds are it's a viral infection.

"Viruses have a different structure and they're not affected by antibiotics at all so when you do take them, some of the good bacteria that you have in your mouth and from your skin are killed," said Edith Blondel-Hill.

She further explains that the bacteria that are not killed can develop a mutation and then learns to become resistant to antibiotics.

Both viruses and bacteria cause infections, but antibiotics only work against bacteria. Bacterial infections don't spread as easily as viral infections.

"Through this program we are trying to teach people about antibiotic resistance and that it's a public health problem," said Blondel-Hill. "If you use antibiotics every time you have a cold, you are going to end up having much more resistant bacteria around ad then you might harbor one of these really resistant ones and for some reason it may not affect you as much but you might transmit it to somebody else. For example, in day cares, kids seem to be more susceptible to viruses because, let's say, people are not washing their hands so they are transmitting those viruses to the kids. Therefore, kids end up taking antibiotics when it's not needed, which leads to them carrying the resistant bacteria and then little Susie who is just sitting there gets coughed on and then she develops meningitis then dies because we can't treat it anymore due to bacteria resistance."

The best thing to do to treat viral infections, suggests Blondel-Hill, is to get a lot of rest, drink a lot of fluids, eat chicken noodle soup because the hot steam kills a lot of viruses before they can replicate, and wash your hands so you don't spread it to others.

"The problem is that we live in a society where everybody thinks there's a cure for everything. Well, there isn't. Prevention is much more important," stressed Blondel-Hill. "Very healthy people who have never taken antibiotics can be exposed to antibiotic resistant bacteria from others," Blondel-Hill warned. "These bacteria are sometimes resistant to many antibiotics and there may not be any way to treat them."

Since the start of this program, Blondel-Hill said it has been evaluated and through data shown from Alberta, Blondel-Hill said they found a decrease in antibiotics. In addition, when she visited Grande Prairie, "we found a 12 per cent decrease in antibiotic use."

She pointed out that antibiotic resistance may be higher in First Nations, especially children, because "partly there may be some predisposition to having more infections."

"Sometimes, depending on their social circumstances, there might be crowding and so they might have more transmission of illnesses."

The Web site, dobugsneeddrugs.org provides information for healthcare professionals, the public, teachers, prents and day care operators in eight different languages.

"Eighty per cent of community infections are spread by hands, therefore proper hand washing is the best way to stop the spread of those infections," said Blondel-Hill.