Antimicrobial Awareness Week, November 18-24

Antimicrobial: Substances such as antibiotics, antivirals, antifungals, and antiparasitics, used to destroy or inhibit the growth of respective microbes.

In the face of the pandemic, worldwide attention has been placed on health, illness and death, and the burden containment has on our livelihoods. We are pressured to consider our personal health and the health of our family and community in ways we are unaccustomed to. We are reminded that being healthy, in the context of a pandemic, is important, but may not be enough. Polarized views exist on prevention, immunity, vaccination, infection control, safeguarding health versus safeguarding the economy, and whether enough is being done to protect Canadians, particularly the vulnerable. While many are immersed in media reportage, others say they are tired of the inundation and unsolicited advice. 

The week of November 18-24 is Antimicrobial Awareness Week. Although we are rightfully focused on COVID-19, we cannot forget the impact of antimicrobial resistance and its effects, particularly as more Canadians are hospitalized with COVID-19.  Unfortunately, some individuals infected with the SARS-CoV-2 virus may require prolonged hospitalization. Furthermore, they may develop additional bacterial or fungal infections that are resistant to first line antimicrobial treatment. Longstanding overuse and misuse of antimicrobial drugs in humans, animals, plants, food, animal feed, and the environment has resulted in the evolution of these stubborn, resistant organisms. Antimicrobial resistant organisms may  be transmitted in healthcare environments putting patients receiving standard care, such as dialysis, surgery, or a C-section at risk.

Antimicrobial drugs are highly valued, but sometimes inappropriately used. Dr. Hanan Balkhy, Assistant Director General for the WHO, emphasises the importance of the right drug, for the right person, at the right time. "Never is someone given an antihypertensive drug or cancer therapy without being diagnosed with cancer or hypertension. Yet, antibiotics are given [at times, unnecessarily] as a gesture of love or care." Unnecessary prescriptions, sharing antibiotics with others, or not completing our prescription contributes to the reduced effectiveness of antimicrobials.

Replenishing the shelves with alternative antimicrobial medications is an arduous research process; therefore as a society, we cannot count on a rapid production of new medications for each resistant organism. We can however, try to avoid infections. In the context of the pandemic there are  proven practices we can participate in—deliberate hand hygiene, distance, don a mask, disinfect, diagnose and detect contacts, and "do not" go out if ill (7Ds).

If we must enter a healthcare facility including longterm care, as a patient or to support loved ones, we must protect ourselves and those we care about. In addition to the 7Ds: don't be shy about reminding healthcare workers to wash their hands and thank them when they do; if the environment doesn't seem clean or equipment such as a thermometer or stethoscope hasn't been disinfected between patients—speak up, until you are satisfied; if you are instructed to wear and subsequently remove a gown, mask and gloves (PPE), ensure you are given the training and support you need to do this safely.

A healthy lifestyle and illness prevention are more important now than ever. We have authority over our health and our behaviours. Healthcare has authority over appropriate antimicrobial use and environmental cleanliness. Let's unite to prevent infection. Let's unite to preserve antimicrobials.

We thank and acknowledge AMMI Canada for their revisions to this article.