Antimicrobial Use and Resistance

Antimicrobial resistance (AMR) refers to changes in infectious organisms (viruses, bacteria, fungi and parasites) so that they can no longer be controlled or treated effectively by standard drugs such as antibiotics, antivirals and antifungals. AMR is an increasingly serious threat to public health and NCCID works with partners across the country to provide evidence and resources on AMR surveillance and antimicrobial use (AMU).

Antibiotic Awareness Week

Antibiotic resistance is an issue health practitioners around the world face daily. Numerous Canadian health-related organizations have partnered in an effort to promote the prudent use of antibiotics and fight the threat of antibiotic-resistant bacteria. It is hoped these efforts will help improve public health in Canada by offering practical tools that focus on the threat of antibiotic resistance.


REPORT: Surveillance of Antimicrobial Resistance and Antimicrobial Utilization in Canada

This report summarizes the results of a 2012–2013 project sponsored by the National Collaborating Centre for Infectious Diseases. The task set forth was both to assess the current status of surveillance of antibiotic or antimicrobial use (AMU) and antimicrobial resistance (AMR) in Canada, and to provide recommendations to advance Canadian surveillance. This project had three main components:

1. A systematic literature search was performed to identify, describe and evaluate Canadian and international AMR and AMU surveillance programs, with analysis of their attributes. A structured evaluation method was applied to exemplar Canadian and international systems, and a more detailed analysis review of two models of surveillance (Denmark’s DANMAP program and the European Centre for Disease Control and Prevention’s EARS-Net and ESAC-Net programs) was performed to identify their relevance, strengths and weaknesses in potential application to a Canadian context.

2. A semi-structured interview protocol surveyed Canadian experts from key stakeholder groups (including but not limited to public health and infectious diseases physicians, physician and PhD microbiologists, antimicrobial pharmacists, veterinarians, and representatives of the food animal industry) to ensure a full understanding of current functioning Canadian AMR and AMU surveillance in all sectors, to identify perceived strengths, and weaknesses, and to identify perceived needs.

3. A review of previous Canadian antimicrobial resistance and surveillance consensus meetings, reports and recommendations to inform the development of an actionable set of recommendations.

Putting the Pieces Together: A National Action Plan on Antimicrobial Stewardship

This document provides a roadmap for improving antimicrobial stewardship (AMS) in Canada and lays out a series of 10 areas for a national Action Plan on antimicrobial stewardship in which governments, healthcare organizations and professionals, civil society groups and the public can collaborate to preserve the effectiveness of antimicrobial drugs such as antibiotics. It is built on the work of 50 experts, key influencers and stakeholders in the field of antimicrobial stewardship (AMS) and antimicrobial resistance (AMR) who met at a national roundtable in June 2016.

Canadian Programs in Antimicrobial Resistance

The Canadian Nosocomial Infection Surveillance Program (CNISP) Report: This summary report for ARO data from January 1, 2013 to December 31, 2017 provides a review of available ARO data in Canada and responds to the requests from hospitals to have access to this data in a timely manner.

The Canadian Antimicrobial Resistance Surveillance System (CARSS) Report provides complimentary data on antimicrobial use and resistance.

The Antimicrobial Resistance and Nosocomial Infections Laboratory at the National Microbiology Laboratory in Winnipeg provides molecular testing of both hospital- and community-acquired strains of MRSA, VRE, and ESBLs.

The Canadian Antimicrobial Resistance Alliance (CARA) provides online data from several surveillance studies of antimicrobial resistant organisms as well as educational resources on antimicrobial resistance.

The Canadian Integrated Program on Antimicrobial Resistance Surveillance (CIPARS) is a federal program for surveillance of enteric pathogens in both human and animal environments, including data collected from farm, retail food, and clinical sites.

IPAC CANADA (Infection Prevention and Control Canada) is a multidisciplinary, professional organization for those engaged in the prevention and control of infections. A number of excellent AMR resources are listed.

AMR surveillance databases

NCCID has also prepared this downloadable list of AMR surveillance databases.

Viral Prescription Pads

(click to enlarge)

Provides information about symptomatic relief for infections and indicates when patients should consider a return visit. To be used with patients (adults and children) who have a suspected viral infection.

To order free copies of the ‘prescription pads,’ click here.

Collected Publications

Antimicrobial Use (AMU) & Resistance (AMR)

Glossary of Terms: Antimicrobial Resistance

The Role of Human Health and Animal Health in Antimicrobial Resistance

A Provincial Antimicrobial Stewardship Program: Successes and Challenges in Alberta

Community-Acquired Antimicrobial Resistance: Consultation Notes

Strategies to Control Community-Associated Antimicrobial Resistance Among Enteric Bacteria and MRSA in Canada: A comprehensive review

Surveillance of Antimicrobial Resistance and Antimicrobial Utilization in Canada

The W-5 of NDM-1: The Pinnacle of Antimicrobial Resistance

Antimicrobial Use and Resistance in Pigs and Chickens: A review of the science, policy, and control practices from farm to slaughter

A Review of Alternative Practices to Antimicrobial Use for Disease Control in the Commercial Feedlot

AMS Directory

The Antimicrobial Stewardship Directory provides information about the commitments and activities of the participants at the 2016 Canadian Round Table for Antimicrobial Stewardship. The activities correspond with the commitments of each member agency as outlined by the Putting the Pieces: A National Action Plan for Antimicrobial Stewardship.

For background documents related to this directory, consult the event page and meeting report on the NCCID website.


NCCID regularly hosts in-person gatherings and on-line events throughout the year, with archived versions of webcasts often available by request.

  • WEBINAR // How Can Antimicrobial Resistance Surveillance Inform Public Health? | April 2019
  • WEBINAR // Multi Drug Resistance in Refugee Population: Lessons to Learn from Europe | September 2018
  • WEBINAR // ASP Foundations Forum – An Exchange of Promising Strategies for Stewardship in Long Term Care | April 2018
  • WEBINAR // Six Features for Success: Stewardship Programs in LTC | Nov. 2017
  • WEBINAR // Antimicrobial Stewardship (AMS) in Atlantic Canada | Oct. 2017
  • WEBINAR // Antimicrobial Stewardship in Long Term Care | March 2017
  • ROUNDTABLE // Canadian Roundtable on Antimicrobial Stewardship | June 2016