Grant: Travel Awards - Institute Community Support

Chronic H.pylori infection increases the risk of peptic ulcers and gastric cancer. Residents of Canadian Arctic communities are disproportionately affected by H.pylori-associated diseases. Standard treatment to eliminate H.pylori has poor effectiveness in this region, due in part to antibiotic resistance of local H.pylori strains. As a preliminary step in investigating the influence of exposure to antibiotics on the prevalence of antibiotic-resistant strains, this analysis describes the antibiotic dispensation rate in Canadian Arctic communities and compares it to that of the Edmonton outpatient population. This analysis used data from projects conducted in 2007-2012 by the CANHelp Working Group in Aklavik, Tuktoyaktuk, Fort McPherson, NT, and Old Crow, YT. Project staff collected data from participants' medical charts on the frequency and type of antibiotic prescriptions for the 5 years preceding project enrolment. Antibiotic dispensation rates in Edmonton for 2010-2013 were estimated from the Alberta Government Interactive Health Data Application. Chart reviews were completed for 297 participants from the 4 communities. The average number of antibiotic prescriptions per participant for the 5-year period was 4.6 (95%CI:4.1,5.1) and this average was higher among females (5.6; 95%CI:4.8,6.4) compared to males (3.4; 95%CI:2.9,3.9). The antibiotic prescription dispensation rate across communities was 0.94/person-year (95%CI:0.89,1.0). In contrast, the dispensation rate in Edmonton was 0.562/person-year (95%CI:0.561,0.563). The rate difference between the northern communities and Edmonton was 0.38/person-year (95%CI:0.33,0.43). This analysis estimates a notably higher antibiotic dispensation rate among residents of Arctic communities relative to the Edmonton outpatient population. This may be due in part to the limited availability of diagnostic technology in Arctic communities, leading to more frequent dispensation of antibiotics prior to confirmed diagnosis.