Think you need antibiotics?

Think Twice. Seek Advice.


Unnecessary antibiotic use and misuse directly contribute to the rise in resistant bacteria. Antibiotic Awareness Week promotes cautious and correct use of antibiotics to help prevent and control the spread of bacteria that develop resistance to the medications.


Antibiotic Awareness Week / Nov. 18-24, 2019

Think you need antibiotics for a cough or cold? For the flu? Sinus aches? Cloudy pee? Toothaches? Think Twice. Seek Advice.

Antibiotics don’t work against your common cold and flu viruses, and are unnecessary for some common bacterial infections.

Overuse or misuse of antibiotics can cause bacteria to develop resistance to these drugs—making antibiotics less effective when you need them the most.

Ask your health professional whether antibiotics are the right treatment for you.

Why a campaign for antibiotics?

Unnecessary antibiotic use and misuse directly contribute to the rise in resistant bacteria. Antibiotic awareness week promotes cautious and correct use of antibiotics to help prevent and control the spread of bacteria that develop resistance to the medications.

According to the Canadian Institute for Health Information (CIHI), overuse and misuse of antibiotics is more common in Canada than in other OECD countries. Respiratory infections account for the greatest amount of overuse, in Canada and abroad. (Canadian Institute for Health Information. Infographic: Do you need that antibiotic? 2017)

• Canadian clinicians prescribe 33% more antibiotics than clinicians in countries like the Netherlands, Sweden and Germany.

• For OECD countries overall, 3 out of 5 antibiotic prescriptions were for diagnoses considered inappropriate such as common colds and related symptoms (e.g., sore throat, cough).

Why use antibiotics wisely?

Antibiotics are lifesaving medications that we rely on to fight and prevent infections. The long lifespans we enjoy, we owe in large part to antibiotics. But despite their potency, like most medications, antibiotics have limitations.

Antibiotics only work to treat conditions caused by bacteria, not those caused by viruses. Antibiotics may also kill some protective bacteria, and may cause some harmful side-effects.

These harms alone are reason enough to avoid unnecessary antibiotic use; some bacterial infections resolve without treatment. But there is also the risk of antibiotic resistance.

What is antibiotic resistance?

Germs like bacteria change when exposed to antibiotics in the body. They develop characteristics that allow them to fend off or disable antibiotics. Bacteria that develop this ‘resistance’ are not killed and continue to multiply.

Resistance in bacteria can pass to other bacteria in your body. They can also be deposited in the environment (water, soil), or spread to others in your family, community, or hospitals. When disease-causing bacteria are ‘resistant’ they can become difficult or impossible to treat.

What harms are expected?

In Canada and around the world there are increasing reports of treatment failures, where resistant bacterial infections are no longer responding to antibiotics. This is already seen for some common infections, like pneumonia and gonorrhea.

This means that many procedures that we rely on will be risky. Routine operations like hip replacement, cesarean section, or appendix removal will become riskier. Without effective antibiotics, patients receiving chemotherapy and others with weakened immune systems will be poorly protected.

Although Canadian data are limited, experts estimate that in some Canadian provinces tens of thousands of illnesses per year result from resistant bacteria.

By 2050, if we continue using antibiotics as we are now, approximately 10 million people worldwide will die from resistant organisms each year, which is more than the number of deaths caused by cancer.

What can be done?

Responsible use of antibiotics can help slow the tide of increasing antibiotic-resistance. Action is needed at all levels—individuals, governments, major organizations—and by all nations.

You can safeguard antibiotics and your health by using antibiotics cautiously, only when necessary, and only as prescribed. Only take antibiotics prescribed to you for your particular illness, and carefully follow medical advice on the dose to take, and how long to take it. Begin by thinking twice—question assumptions and ask healthcare providers for advice.


Everyone can help limit the misuse and overuse of antibiotics, and combat antibiotic resistance. Explore and share the resources below to help keep antibiotics working for you, and for all Canadians.


‘Think Twice’ about whether antibiotics are needed or not for some common illnesses like coughs, colds, flu, sore throat or sinus pain. Seek advice from your healthcare provider on the treatment that is right for you.

Be aware of the risks and human costs of drug-resistant bacteria. See the personal stories shared below.



VIDEO: ‘Antibiotic Awareness Week’

A complete and high-quality source of information for the public, this website provides videos and specific information about antibiotic use and antibiotic resistance. Learn about when and when not to use antibiotics—use the pull-down menu to learn more about conditions that concern you. Learn more.

Guide to Wise Use of Antibiotics

This 12-part online guide, produced by Do Bugs Need Drugs?, helps you build knowledge on appropriate antibiotic use. It begins with understanding that not all ‘bugs’ are the same: many do not respond to antibiotics. Learn about types of microbes that cause illness, how to wash your hands to effectively stop the spread of infectious illnesses, treatments for symptom relief, and what signs or symptoms signal the need for medical attention. Learn more… click here.

Say Naaah: Open up and think twice about antibiotics

Learn more about the use of antibiotics and dental care, and why they may not be needed for every condition. A factsheet and other resources are provided by, B.C.’s leader on antibiotic awareness. “Preventing infection”: this video shows how antibiotics fight and prevent infection and can help in modern dentistry practice.

Using Antibiotics Wisely, Patient Pamphlets

The ‘Using Antibiotics Wisely’ series focuses on reducing unnecessary antibiotic use. Topics include: needless use of antibiotics for respiratory infections, sinus infections, and bacteria in seniors’ urine that cause no illness, as well as hospital procedures that increase the risk of infection. To read, click here

Let’s talk factsheets

Produced by Public Health Ontario, this series of 5 factsheets provides guidance on antibiotics and when they are not needed for some common infections. Topics include: Ear Infection, Sinus Infection, Sore throat, Bronchitis, and Do you need antibiotics?

Antibiotic (antimicrobial) resistance

Resources from the Public Health Agency of Canada (PHAC) help prevent antibiotic resistance, with information on its causes, impacts and which bacteria and illnesses are antibiotic-resistant. PHAC also offers prevention tips and advice on when and how to use antibiotics.

Antibiotics & You

This animated video introduces you to your ‘microbiome’, challenges common assumptions about antibiotics, and arms you with questions to ask healthcare providers. Produced by Biomedical Communications students with support from the Sinai Health System–University Health Network. Watch it here.

Why is Antimicrobial Stewardship Important?

A video explaining antimicrobial resistance and what it means to be a ‘steward’ of antibiotics, including getting patients the right antibiotics when they need them. Shared by a Canadian leader in stewardship, the Sinai Health System-University Health Network. Watch it here.

Be antibiotic wise: Antibiotic Quiz

Test your knowledge on appropriate antibiotic use and possible consequences of misuse. Southern Health-Santé Sud and Do Bugs Need Drugs? ask: Are you antibiotic wise? Take the quiz here

I Boost Immunity: materials for Antibiotic Awareness Week

Produced as part of the 2018 Antibiotic Awareness Week, these materials include an article entitled Do you REALLY need antibiotics for that cold or flu?, a short video and a four-question quiz. The materials promote prevention in an effort to control the spread of bacteria that develop resistance to antibiotics. Find out more: click here.



What happens when antibiotics stop working? Learn about the possible harms of drug-resistant bacteria from those who have experienced an infection during a hospital stay, while traveling, or from an unknown source in their community.

Let these stories inspire you to learn and do more to use antibiotics wisely. Share them on social media to help build awareness.

Patient Story: Mary

Mary’s story chronicles a nine month collection of family emails after she caught an infection post-surgery. The email subject lines were alerts, meant to be opened immediately, and at times a call to action. Read her full story here (Source: Health Canada).

➤ SHARE her story: Facebook | Twitter | LinkedIn

Patient story: Lill-Karin

Lill-Karin, Norway, caught bacteria resistant to many antibiotics after an accident and a hospital stay while on holiday abroad. The strain of bacteria was so resistant that there was only one antibiotic available that could be used to treat it. She spent a long time in and out of hospitals to get rid of the infection. Read her story.

➤ SHARE her story: Facebook | Twitter | LinkedIn

Patient story: Paolo

Paolo fell ill with a serious urinary infection with an E.coli resistant to many antibiotics. It took two months and three courses of different antibiotics before Paolo’s infection was successfully treated. Nobody knows where he picked up the infection. Read his story.

➤ SHARE his story: Facebook | Twitter | LinkedIn

Patient story: Mohammed

The bacterium that was isolated from Mohammed’s bloodstream was resistant to many antibiotics, including the last-source antibiotics—a class of last-line antibiotics called carbapenems. Mohammed’s doctors were able to successfully treat him with the correct antibiotics, because they had taken cultures in time and performed laboratory testing to see which antibiotics were effective against his bacterium. Read Mohammed’s story (Source: ECDC)

➤ SHARE his story: Facebook | Twitter | LinkedIn

Patient Story : Doris

Doris Anderson, a very active 94 year old Prince Edward Island resident, explains improvements with her urinary tract infections after using vaginal estrogen supplementation, vaginal probiotic, correct sampling technique, rapid testing, and rapid treatment with a low toxicity antibiotic. Watch this video here

➤ SHARE her story: Facebook | Twitter | LinkedIn




In the interest of quality patient care and public health, healthcare professionals have a responsibility to prescribe antibiotics only when required and to select the right drug, dose and duration. Members of the healthcare team help patients and their caregivers to weigh the risks and benefits of antibiotic use, and offer guidance on symptom relief when antibiotics cannot help. Below are links to several evidence-based tools and educational resources developed by clinical leaders and champions of antibiotic stewardship.

Using Antibiotics Wisely

Choosing Wisely Canada’s antibiotics campaign website provides information about how to use antibiotics wisely. Recommendations for primary care, hospital and long-term care prescribers, prescription handouts (viral prescription & delayed prescription), posters for patient waiting rooms, and other patient resources are also available for download to use in your practice. Access here.

Prescribe antibiotics wisely (Clinical points)

The Public Health Agency of Canada offers a resource for health care providers to help them increase their awareness about antibiotics overuse and misuse and how it can contribute to antibiotic resistance. Key clinical points on asymptomatic bacteriuria, upper respiratory infections, and vaccination are featured. Read it here

Preventing Infections in the Hospital: Watch out for these two practices

This resource from Choosing Wisely Canada (CWC) describes how both urinary catheters and ulcer drugs, mostly over-used in hospitals, can increase the risk of infection. To read it, click here

Viral Prescription Pads

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

Symptom-Free Pee: Let It Be (#symptomfreeletitbe)

The Association of Medical Microbiology and Infectious Disease (AMMI) Canada, has developed bilingual resources freely available for download to stop inappropriate antibiotic use for asymptomatic bacteriuria in long-term care residents. Acute care resources coming soon. To read the Symptom-Free Pee: Let It Be, click here.


Although reported as ten per cent of Canadians, true penicillin allergies are uncommon to rare, and in the past using antibiotics in the bigger “beta-lactam” family were disregarded. This has led to poorer outcomes and collateral damage including superbugs like C. diff and MRSA. AMMI Canada will provide a clearinghouse of the toolkits currently available and promote antibiotic safety during AAW. Read more here

Antimicrobial Stewardship Essentials

Public Health Ontario (PHO) offers public health and healthcare practitioners practical and evidence-based information on how to promote antimicrobial stewardship in a range of healthcare settings. This includes a new resource tailored to Long Term Care. To read, click here

Antimicrobial Stewardship Programs Chat

#ASPchat is a monthly, real-time Twitter Chat that aims to promote appropriate antibiotic use by stimulating conversation about antimicrobial stewardship. Chats are open to all and run on the third Thursday of each month from 7-8 PM EST. Join the November 15 chat “Antimicrobial stewardship and awareness for the cause,” and follow @ASP_chat for news of more upcoming events.

Antibiotics and dental care

Resource produced by AntibioticWise to provide useful information on antibiotic overuse and antibiotic needs for dental care. To know more, click here

Say Naaah: Open up and think twice about antibiotics

A poster from the campaign to raise dentists’ and public awareness about toothaches, oral infections and antibiotics. To see it, click here


Healthcare providers and public health leaders are witnessing the human and health system costs of antibiotic resistance, in Canada and around the world. Their stories illustrate adoption of effective practices or policies, and improved outcomes for patients. Read and share stories that inspire you to act on the threat of antibiotic or antimicrobial resistance.

“Clinicians and laboratorians: Pharmacist” >  Download

“Clinicians and laboratorians: Primary care physician” >  Download

“Clinicians and laboratorians: Infection disease specialist” > Download

Dr. Yoav Keynan, NCCID Scientific Lead > Download

Antibiotic Story : The 7 Minutes

Prince County Hospital ER is a shining star on wise antibiotic use for the province of PEI. The 7 minutes spent explaining why a patient doesn’t need antibiotics is worth it, especially considering a new CMPA warning. To watch the video, click here

Antibiotic Story : You get the virus, you need a virus plan

In this video, Peters Wayne, Dr. Navqui and Greg Burton, community pharmacists from PEI, share their experiences with antibiotic prescription, advice to patients regarding antibiotic use, and antibiotic use home care (long-term care) facilities. Watch it here

Antibiotic Story : Moxifloxacin

If current practices prevail, more people will die from antibiotic resistance than cancer by 2050. Healthcare providers are encouraged to apply innovative strategies and to engage in conversations with patients. In this video, Sarah Lutes, a Hospital Pharmacist in PEI, shares her story about community acquired pneumonia (CAP) and how a guidelines developed by Health PEI helped to stop unwise prescribing of Moxifloxacin. Watch it here


The emergence, development and spread of pathogenic organisms resistant to treatment by antibiotics and other essential drugs is a worldwide public health concern. The knowledge and capabilities of all nations must be harnessed to combat antibiotic and antimicrobial resistance (AMR).

Several allied awareness campaigns are featured here, listed by country. Foremost among them is the global campaign, led by the Tripartite Collaboration (WHO/FAO/OIE). Together, these initiatives illustrate the emergence of a vast international movement to mobilize against AMR.


World Antibiotic Awareness Week / World Health Organization (WHO) / Food and Agriculture Organization (FAO) / World Organisation for Animal Health (OIE)


U.S. Antibiotic Awareness Week / Centers for Disease Control and Prevention (CDC)


European Antibiotic Awareness Day : A European Initiative / European Centre for Disease Prevention and Control (ECDC)


Antibiotic Guardian / Public Health England


Antibiotic Awareness Week / Australian Commission on Safety and Quality in Health Care



The campaign

Antibiotic Awareness Week, November 18-24, 2019, is a time to raise awareness for correct and cautious use of antibiotics to help control the increase in resistant bacteria and hard-to-treat infections. Held every November, the event coincides with World Antibiotic Awareness Week, led by global champions for the responsible use of antibiotics.

In Canada, the campaign is led by the National Collaborating Centre for Infectious Diseases (NCCID), joined by leaders in public health, antimicrobial stewardship, quality healthcare, and patient safety. This year our focus is Think Twice. Seek Advice, asking Canadians to check their assumptions and speak to their healthcare providers about when antibiotics are needed and when they are not. Areas of emphasis for this campaign are common respiratory infections and suspected bladder infections among the elderly—where misuse is common—as well as dental care. Improved awareness on when antibiotics may not be called for can lead to improved use and help limit the harmful effects of drug resistance.

On this page, visitors will find many resources to help promote the appropriate use of antibiotics. The public will find informative videos, factsheets, quizzes as well as links to more comprehensive educational resources and allied campaign websites. For providers, there are evidence-based clinical practice recommendations and patient education tools to download and share, as well as aids to antibiotic stewardship program planning.

Follow @CentreInfection on Twitter to share campaign messages and materials during Antibiotic Awareness Week, November 18-24, 2019.

Please return to this webpage to see what’s new, as more resources will be added.


At the National Collaborating Centre for Infectious Diseases, we specialize in forging connections between those who generate and those who use infectious disease public health knowledge.

Working across disciplines, sectors and jurisdictions, NCCID is uniquely situated to facilitate the creation and operation of networks and partnerships. From policy to practice, we’re able to build bridges between those with infectious disease questions, those with answers, and those in a position to act on the evidence. NCCID is funded by the Public Health Agency of Canada and hosted by the University of Manitoba.


For more information, or to ask how your organization can endorse the campaign, please contact the National Collaborating Centre for Infectious Diseases.


Partners |  Twitter: @AMMICanada | Twitter: @Patient_Safety | Twitter: @CPhAAPhC | Twitter: @ChooseWiselyCA | Twitter: @DoBugsNeedDrugs | Twitter: @antibioticwise | Twitter: @HealthCareCAN | Twitter: @IPACCanada | Twitter: @centreinfection


Website | Twitter: @GovCanHealth, @CPHO_Canada | Twitter: @PublicHealthON


Sinai Health System-University Health Network | Twitter: @SinaiHealthTO, @SHSUHNASP