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In response to growing concerns over worldwide anti-microbial resistance (AMR), the World Health Organization (WHO) released a report entitled, ‘Antimicrobial resistance: global report on surveillance 2014’. They found that antimicrobial resistance is occurring everywhere in the world, compromising the ability to treat infectious diseases, as well as undermining many other advances in health and medicine.

An antimicrobial medication is an agent that kills microorganisms or inhibits their growth. All antibiotics are antimicrobials, but not all antimicrobials are antibiotics as the class of medication also includes all agents that act against all types of microorganisms – bacteria (antibacterial), viruses (antiviral), fungi (antifungal) and protozoa (antiprotozoal).

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Dr. Keiji Fukuda, WHO’s Assistant Director-General for Health Security issued a stern warning that, “without urgent, coordinated action by many stakeholders, the world is headed for a post-antibiotic era, in which common infections and minor injuries which have been treatable for decades can once again kill. Effective antibiotics have been one of the pillars allowing us to live longer, live healthier, and benefit from modern medicine. Unless we take significant actions to improve efforts to prevent infections and also change how we produce, prescribe and use antibiotics, the world will lose more and more of these global public health goods and the implications will be devastating.”

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In Canada, the Public Health Agency of Canada released a report entitled ‘Human Antimicrobial Drug Use Report 2012/13’ to better understand the trends of use over time on a provincial and national level.

Some highlights of the report include:
– In 2013, doctors in office based settings saw patients for more that 293 million diagnoses, resulting in 23.8 million antimicrobial recommendations (accounting for 8% of all diagnoses)
– Children between 3 and 9 years had the highest percentage of diagnoses with an antimicrobial prescription (mostly pencillins and macrolides)
– Parenteral products (ie. antimicrobials either injected or supplied intravenously) increased 200% in use total volume used from 2012 to 2013
– Total kilograms of active antimicrobial ingredients purchased by hospitals increased 75% between 2010 and 2013

Although the Public Health Agency of Canada keeps records on the use of antimicrobials in humans, there is very little oversight and tracking of the use of them in food-producing animals and livestock. They are routinely used in feed for growth promotion and to prevent infections in food-producing animals.

Many types of antimicrobials, such as ionophores, are used simply to increase the weight in the animals and are not used for a medical reason. Some drugs can be purchased and imported into Canada without a veterinary prescription and used outside the approved levels with a veterinary prescription.
The unnecessary use of antimicrobials for agricultural and livestock purposes may lead to the evolution of resistant strains. Later, these strains will not be able to be controlled by medication when it really is necessary. Pathogens and commensal organisms resistant to these drugs in animals can be transmitted to humans. The negative health consequences of this are just being discovered.

In the US they keep better track of antimicrobial use in livestock although there are no restraints to limit how much they are administering. In December 2015, the Center for Veterinary Medicine Protecting Human and Animal Health, within the Food and Drug Administration, released a report entitled, ‘2014 Summary Report on Antimicrobials Sold or Distributed in Food-Producing Animals’. It is a comprehensive report outlining antimicrobial use in food-producing animals in the US.

Key highlights of the report:

⁃ Domestic sales and distribution of antimicrobials approved for use in food-producing animals increased by 22% from 2009 through 2014
⁃ The use of ionophores (classed as a ‘non-medically important antimicrobial’ and used as a feed additive to increase weight gain in cattle) has increased by 26% from 2009 through 2014
⁃ It’s widespread and legal to use antibiotics to increase weight gain in food-producing animals but ‘because of confidentiality constraints, FDA cannot provide sales and distribution data for products labeled solely for production indications.
⁃ Tetracyclines and ionophores account for the largest sales in volume by kg

Things may be changing in Canada. In March 2015, the Public Health Agency of Canada, in collaboration with multiple other government agencies, released a ‘Federal Action Plan on Antimicrobial Resistance and Use in Canada’.

Key actions over the next two years:
1. Establish and strengthen surveillance systems to identify new threats or changing patterns in antimicrobial resistance and use, in human and animal settings.

2. Strengthen the promotion of the appropriate use of antimicrobials in human and veterinary medicine.

3. Work with the animal agriculture sector partners to strengthen the regulatory framework on veterinary medicines and medicated feeds, including facilitating access to alternatives, and encourage the adoption of practices in order to reduce the use of antimicrobials.

4. Promote innovation through funding collaborative research and development efforts on antimicrobial resistance both domestically and internationally.

So what can we do on an individual level to reduce AMR? Prevention is always the best medicine. Supporting our immune systems by getting proper rest, exercise, and nutrition can go a long way to preventing illness. Using natural and herbal products like echinacea, oregano oil, or elderberry tincture can be a good first option.
If there are repeat infections with only temporary relief from antimicrobial medication, consider seeking constitutional treatment by a qualified classical homeopath. The aim in treatment is to reduce and eliminate their occurrence as well as resolve the symptoms.
There is usually a small window of time when the infection is just starting where it can be halted by a homeopathic remedy and no conventional medication is deemed necessary. This author has dozens of such cases in her practice.

If antimicrobials are needed it’s important to complete the full prescription even if symptoms resolve beforehand. After taking antibiotics consider a course of probiotics to help restore gut flora.

We all have a part to play in reducing antimicrobial resistance and using lifestyle preventative measures and natural products as a first line of defense may just be what the doctor ordered.