If antibiotic overuse is alarming to government, fund solutions: expert

Health Minister John Haggie, you should give Dr. Jim Hutchinson a call.

He has some advice on how to address antibiotic overuse.

As a microbiologist and former chief of infection control at Eastern Health, Hutchinson was the pioneer when it came to raising concerns about their overuse, offering solutions and putting the issue in the national spotlight. Two decades ago, he spearheaded the Newfoundland Optimal Antibiotic Use Project.

“I am really happy to see this again is being highlighted again as an issue,” Hutchinson said in a telephone interview over news Haggie had raised alarms this week about antibiotic overuse and the worsening potential for anti-microbial resistance.

“But I am quite dismayed at the level of the health minister it wasn’t accompanied by resource allocations. If he wants some ideas about how to do it, Dr. Hutchinson is willing to talk.”

“The places that have had the most success in dealing with this issue, just like any other issue, are the ones that put some resources towards it. … He knows the story. If he is so interested in it, get it in the budget.”

In 2011, Hutchinson moved on to head the Island Health Antimicrobial Stewardship Program as its medical director in British Columbia.

Hutchinson said that Haggie, as a former surgeon, former head of the medical association and now as minister of Health, should be in the driver’s seat to implement the much-needed solution of putting resources on urgent issues.

“Get in the cabinet and get some money going,” Hutchinson said. “If you want to make inroads with the problem, start with the dollar figure.”

After government released Budget 2018 Tuesday, Haggie, in response to questions, gave reporters a grave message about antibiotic overuse.

But it was far from new for anyone who had listened to Hutchinson years ago.

“(Haggie’s) talking about Newfoundland being high. I was the guy standing on the stage 20 years ago describing how high,” he said.

“We were pioneers in 1997. In fact, in St. John’s now there is a pretty active clinical pharmacybased antibiotic stewardship program that’s very effective and has been for a long time. … At the clinical pharmacy end, it’s superb. … Here’s an example of a thing we were able to operationalize because we did move some money around internally. It’s actually the model for what I am doing here. … We did make some sort of inroads … but my problem always was you need more pots of money saved. By using different and less antimicrobials you could certainly pay for other people’s jobs.

“We were the darlings of the Heath Sciences Centre in the late ’90s because we reduced the antibiotic budget by $500,000 a year, which was the only time the global budget for drugs year over year went down.”

Haggie sounded antibiotic alarms on budget day during media scrums.

“We in this province use twice as much in the way of antibiotics per capita as any other jurisdiction in North America, be it Canada or the States. Our biggest emerging public health problem in the next five years is going to be anti-microbial resistance,” Haggie told reporters.

“This problem could put acute health care back into the 1920s. It’s that big a problem. … We as a government have a great deal of difficulty, though, in legislating professional practice. We can help the regulators regulate, but it would be inappropriate for a politician to be telling a prescriber how to prescribe.”

Haggie said the death rate from sepsis — a potentially deadly illness related to the body’s attempt to deal with an infection, causing major tissue and organ damage — will start to rise as antibiotics become less effective.