Ticks don't jump. They don't fly, and they don't drop out of trees — that's folklore. What they actually do is climb to the tip of a blade of grass, stretch their front legs out, and wait. Sometimes for weeks. It's called questing, and it's a patience game the tick almost always wins, because the host walks straight into it. By the time your patient is standing at the counter with one sealed in a sandwich bag, the waiting is over and a different clock has started ticking. In Ontario, part of that clock is now yours. Good morning. 🫡
Main Story
The 72-Hour Window Is Yours Now
Tick season is here. So is the data that settles whether pharmacist prescribing actually works.
What happened: In February, Public Health Ontario published a review of pharmacist antibiotic prescribing that quietly ended an argument the profession has been having since 2023. Between 2023 and 2024, Ontario pharmacists submitted more than 1.47 million minor-ailment claims — about a third for uncomplicated UTIs, a smaller slice for Lyme disease prophylaxis. The verdict: pharmacist prescribing lined up with antimicrobial stewardship, not against it.
So what: The fear when prescribing expanded was an antibiotic free-for-all. The data went the other way. For UTIs, pharmacists leaned on first-line nitrofurantoin while physician ciprofloxacin prescribing dropped. For Lyme, pharmacists have held authority since 2023 to assess a high-risk tick bite and prescribe single-dose doxycycline for post-exposure prophylaxis. And right now — mid-June, peak questing season, with blacklegged ticks established across Toronto, Durham, Ottawa and pushing into new territory — that's the authority about to get a workout. The patient with a tick in a bag isn't a referral. They're a 72-hour clock, and you're the fastest access point in town.
Now what: Know the criteria cold, because the window is unforgiving. Single-dose doxycycline is on the table only when the tick is a blacklegged (Ixodes scapularis) adult or nymph, attached 24+ hours, acquired in a risk area where more than 20% of ticks carry Borrelia, and removed within the last 72 hours — with no doxycycline contraindication. Miss any one of those and it's educate-and-monitor, not a prescription. Pregnancy is no longer an automatic no; and if doxy is out, there is no second-line substitute for prophylaxis. The PHO assessment-and-prescribing algorithm is the one-pager to keep within reach of the counter all summer.
⚡ Rapid Fire
🐙 An octopus just passed a test most toddlers fail. At Dartmouth, three California two-spot octopuses learned to use a mirror to find food they couldn't see directly — choosing correctly 73% of the time. It's the first time any invertebrate has done it, a trick previously seen only in mammals and birds. Cephalopods split from our lineage 500+ million years ago. Convergent genius.
🚽 A laxative is trying to escape the pharmacy. NAPRA's national scheduling committee met June 7 to weigh moving bisacodyl 10 mg suppositories (10-packs) to unscheduled — open-shelf, grab-it-anywhere status. Nothing's final until an interim recommendation clears a 30-day consultation. But if it goes through, one more product walks off your behind-the-counter shelf and into the front aisle.
📋 There's now a national map of what pharmacists are actually trained to do. CPhA's National Benchmark for Pharmacy Practice — a first-of-its-kind reference — lays out the full slate of services pharmacists are educated to provide, and anchors its PharmacistsCAN campaign. Useful ammunition next time someone asks why your scope should grow. Worth a bookmark.
🥤 The World Cup added a new wrinkle: mandatory hydration breaks. Every match now pauses around the 22nd and 67th minute for a three-minute drink — a tournament first, blamed on brutal North American heat (and, critics say, on selling a few more ads). And Canada? On home soil, its first-ever men's World Cup point. 🇨🇦
THE PICK: 🦟 PureGard — a Canadian-made (Nova Scotia) botanical repellent built around 30% oil of lemon eucalyptus / PMD, Health Canada–registered, started by a mom who went looking for a DEET alternative after her own kids caught Lyme. It's a legitimate tick-and-mosquito option at a concentration most "natural" sprays can't touch — the older 10% Canadian products gave roughly two hours; this one claims about five. The counter catch worth knowing: the box and the online listings call it suitable "for children," but Health Canada and the PMRA restrict PMD to ages 3 and up, and it's not for infants under six months. So when a parent reaches for it for a toddler, that's your correction to make.
💬 Counter Talk
Everyone warned that letting pharmacists prescribe would turn into an antibiotic free-for-all. Ontario's own data says the opposite happened: assessments shifted prescribing toward first-line agents and away from the broad-spectrum stuff. Turns out the people who read drug monographs for a living are pretty good at using them.
That's it. If this landed, forward it to a pharmacist who'd get it. If something was wrong, missing, or worth arguing about — hit reply. We read everything at [email protected].
— The Sig Happens Team 💊